Microorganisms (Mar 2021)

The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital

  • Timothy A. Erickson,
  • Flor M. Munoz,
  • Catherine L. Troisi,
  • Melissa S. Nolan,
  • Rodrigo Hasbun,
  • Eric L. Brown,
  • Kristy O. Murray

DOI
https://doi.org/10.3390/microorganisms9030526
Journal volume & issue
Vol. 9, no. 3
p. 526

Abstract

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Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy.

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