F1738 june 2003 with 1,4 reads how we measure reads. Neonatal bacterial meningitis pediatrics merck manuals. It is characterized by an infection of the central nervous system cns and caused by a limited range of bacteria. Introduction neonatal meningitis nm is a serious disease with substantial mortality and morbidity even among treated neonates overall, 1970.
Systemic bacterial and fungal infections in infants in australian neonatal units. Neonatal bacterial meningitis is an uncommon but devastating infection. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. Group b streptococcus, enteric gram negatives in young infants. Cranial sonography crs has a crucial role in assessment of infants with clinical suspicion of bacterial meningitis as well as follows up of its complications. Twelve years ago an annotation was published in archives of disease in childhood regarding the antibiotic treatment of suspected neonatal meningitis. Cefotaxime, or ceftazidime for pseudomonas meningitis, should be satisfactory when used singly or in combination with an aminoglycoside.
Acute bacterial meningitis in infants and children the. Take steps to educate yourself about the condition before you have a baby so that you can be familiar with. Group b streptococcus gbs is the most common cause of neonatal meningitis. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. Neonatal meningitis is often caused by group b streptococcus and is associated with prematurity, gestational age, postnatal age, and geographic region. Csf outflow resistance is elevated and inhibits csf flow from the subarachnoid space to the dural sinuses. Neonatal bacterial meningitis continues to be an important cause of mortality and morbidity. The bacteria are found in the mouth, throat, or nose. Bacterial meningitis continues to be an important cause of mortality and morbidity in neonates and children throughout the world. It is an overwhelming infection with a high morbidity and mortality rate, especially in neonates. Neonatal meningitis leads to deafness, blindness, cerebral palsy, seizures, hydrocephalus or cognitive.
Clinical practice guideline summary clinical practice guidelines for the acute management of infants and children with bacterial meningitis. Despite improvements in neonatal intensive care, neonatal bacterial meningitis continues to be a serious disease with mortality rates varying. In one case, the cord was cut using a pair of contaminated scissors. Long term outcome of neonatal meningitis adc fetal. Bacterial meningitis is a lifethreatening condition that requires prompt recognition and treatment. Despite advances in infant intensive care, neonatal meningitis remains a devastating disease. Neonatal meningitis is a serious medical condition in infants that is rapidly fatal if untreated.
Management of neonates with suspected or proven early. The treatment, prognosis, and complications of neonatal bacterial meningitis are discussed separately, as is bacterial meningitis in older children. Management of bacterial meningitis in infants bacterial meningitis 6. Practice guidelines for the management of bacterial meningitis. Bacterial meningitis usually leads to a neutrophil predominance in csf, typically between 80% and 95%. Suspected bacterial meningitis is a medical emergency and needs. There are approximately 350 cases of neonatal bacterial meningitis each year in the uk. It is more common during the neonatal period than at any other age.
Emerging pathogens in neonatal bacterial meningitis. The mortality rate has declined from almost 50 percent in the 1970s to contemporary rates of 7 to 18 percent 25. Bacterial meningitis is still a major public health threat in developing countries. Diagnosing and treating meningitis in babies in a neonatal.
Bacterial meningitis is the infection of the protective membranous linings around the brain by bacterial pathogens and can occur at any age. Clinical prognosis in neonatal bacterial meningitis. Neonatal bacterial meningitis cohort full text view. Although most strains of li do not cause meningitis, infections may occur if the bacteria invade areas of the body in which they are not normally found, such as the meninges protective layers surrounding the brain. Although the occurrence of neonatal meningitis is uncommon, it remains a devastating infection with high mortality and high morbidity. Pathophysiology of neonatal acute bacterial meningitis. Duration of therapy duration of treatment for bacterial meningitis. Bacterial meningitis in the neonate may occur in as many as 1 in 2,000 live births in developed nations and in a significantly higher percentage of. Distinguish bacterial, viral, tuberculous, and fungal meningitis based on clinical presentation and cerebrospinal fluid analysis. Despite improvements in neonatal intensive care, neonatal bacterial meningitis continues to be a serious disease with mortality rates varying between 10 and 15%. Meningitis is an inflammation of the meninges, the protective membranes of the central nervous system, is more common in the neonatal period infants less than 44 days old than any other time in life, and is an important cause of morbidity and mortality globally. Neonatal bacterial meningitis is uncommon but associated with high mortality and morbidity.
Neonates are a particularly susceptible population. Neonatal bacterial meningitis pediatrics msd manual. List the typical clinical manifestations of meningitis. Bacterial meningitis also produces effects on blood vessels in the subarachnoid space with resulting vasculitis, vessel narrowing, thrombosis, and ischemia or infarction of the brain. The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. For neonatal meningitis caused by gramnegative enteric bacilli, specific therapy should be based on results of susceptibility studies. Isaacs d, barfield cp, grimwood k, mcphee aj, minutillo c, tudehope di. Neonatal meningitis is an uncommon but serious disease, with an incidence of 0. Predicting the outcome of neonatal bacterial meningitis. It can be treated with appropriate antibiotics that also prevents spread. Meningitis can result from many causes, both infectious and noninfectious. Escherichia coli has recently become the most common pathogen isolated from verylowbirthweight infants with meningitis.
Diagnosing and treating meningitis in babies in a neonatal unit this section is only about newborn babies who have suspected or confirmed meningitis who are in a neonatal unit. Neonatal bacterial meningitis is a major disease that results in death and significant morbidity worldwide. Recommendations are based on the current evidence from literature and incorporate nice bacterial meningitis and meningococcal septicaemia guideline cg102. Neonatal bacterial meningitis is inflammation of the meninges due to bacterial invasion. Neonatal meningitis is a severe acute infectious disease of the central nervous system and an important cause of morbidity and mortality worldwide. Recognize the common acute complications of meningitis. Bacterial meningitis in the infant pubmed central pmc. Second edition 2011 this manual summarizes laboratory techniques used in the isolation and identification and characterization of neisseria meningitidis the meningococcus, streptococcus pneumoniae the pneumococcus and haemophilus influenzae from. The aim of this study was to determine the prevalence. Beyond the newborn period, the most common causes of bacterial meningitis are neisseria meningitidis, streptococcus pneumoniae, and haemophilus influenzae. The inflammatory reaction involves the meninges, the subarachnoid space and the brain parenchymal vessels and contributes to neuronal injury. The epidemiology, etiology, clinical features, and diagnosis of bacterial meningitis in the neonate will be discussed here.
However, meningitis occurs in infants with normal csf. Group b streptococcus, gram negative rods and lysteria monocytogenes. For information about bacterial meningitis for babies not in neonatal units or to read the information for the public about the bacterial meningitis and meningococcal. The authors recommended the use of cephalosporins rather than chloramphenicol and advocated intraventricular aminoglycoside treatment in selected cases. The most common causes have been streptococcus pneumoniae, neisseria meningitidis, haemophilus influenzae type b hib, group b streptococcus gbs, and listeria monocytogenes table 1. The incidence of bacterial meningitis ranges from 0. Additionally, longterm complications are observed among 2050% of survivors, depending on time of diagnosis and therapy and virulence of the infecting pathogen. Neonatal bacterial meningitis bm is a devastating infection that occurs more commonly in neonates than in any other age group, and is associated with significant morbidity and mortality, especially in developing countries. Appreciate how meningitiscausing bacteria penetrate the blood brain barrier, the essential step in the development of neonatal meningitis. A low glucose concentration is the csf variable with the greatest specificity for the diagnosis of meningitis. Neonatal bacterial meningitis nm continues to be a serious disease with an unchanging rate of adverse outcome of 2060%, despite a worldwide decline in mortality.
Refer to neonatal dosing guideline for antibiotic doses and intervals. The introduction of the protein conjugate vaccines against haemophilus influenzae type b, streptococcus pneumoniae, and neisseria meningitidis has changed the epidemiology of bacterial meningitis. Laboratory methods for the diagnosis of meningitis caused by neisseria meningitidis, streptococcus pneumoniae, and haemophilus influenzae. Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. They noted the absence of clinical trials with third generation cephalosporins that. Describe key management issues for a child who has bacterial meningitis. The inflammation is caused by a bacterial infection and can be lifethreatening. Signs are those of sepsis, cns irritation eg, lethargy, seizures, vomiting, irritability particularly paradoxical irritability, nuchal rigidity, a bulging or full fontanelle, and cranial nerve abnormalities. Meningitis is an infection of the meninges, the membrane covering the brain. Bacterial meningitis is more common in the first month than at any other time of life 1. Contributing factors to such mortality and morbidity include our incomplete knowledge on the pathogenesis of how meningitis causing bacteria penetrate the blood brain barrier, emergence of antimicrobial resistance, and difficulty in early diagnosis of meningitis.
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