Bacterial Meningitis in Infants - 11/02/15

Doi : 10.1016/j.clp.2014.10.004

Lawrence C. Ku, MD ^a, Kim A. Boggess, MD ^b, Michael Cohen-Wolkowiez, MD, PhD ^a,^⁎
^a Department of Pediatrics, Duke Clinical Research Institute, Box 17969, Durham, NC 27715, USA
^b Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, CB 7570, Chapel Hill, NC 27599-7570, USA

^∗Corresponding author.

Résumé

Neonatal bacterial meningitis is uncommon but devastating. Morbidity among survivors remains high. The types and distribution of pathogens are related to gestational age, postnatal age, and geographic region. Confirming the diagnosis is difficult. Clinical signs are often subtle, lumbar punctures are frequently deferred, and cerebrospinal fluid (CSF) cultures can be compromised by prior antibiotic exposure. Infants with bacterial meningitis can have negative blood cultures and normal CSF parameters. Promising tests such as the polymerase chain reaction require further study. Prompt treatment with antibiotics is essential. Clinical trials investigating a vaccine for preventing neonatal Group B Streptococcus infections are ongoing.

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Keywords : Neonatal bacterial meningitis, Very low birth weight, Lumbar puncture, Cerebrospinal fluid, Antibiotics, Vaccine

Plan

Funding support: Dr Ku receives research support from the National Institute of Child Health and Human Development (5T32GM086330-03 [Principal Investigators: Brouwer, Benjamin, Watkins]). Dr Boggess receives research support from the National Institute of Child Health and Human Development (5T32HD040672-13 [Principal Investigator: Boggess]; 5K12HD001441 [Principal Investigator: Orringer]; 1R01HD064729-01A1 [Principal Investigator: Tita]), the National Center for Advancing Translational Sciences of the National Institutes of Health (1UL1TR001111), and Research Point Corporation, Inc. Dr Cohen-Wolkowiez receives support for research from the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR001117), the Food and Drug Administration (1U01FD004858-01), the Biomedical Advanced Research and Development Authority (BARDA) (HHSO100201300009C), the nonprofit organization Thrasher Research Fund (www.thrasherresearch.org), and from industry for drug development in adults and children (coi.jsp).