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. 2021 Mar 4;9(3):526.
doi: 10.3390/microorganisms9030526.

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

Timothy A Erickson  1   2 , Flor M Munoz  3 , Catherine L Troisi  2 , Melissa S Nolan  4 , Rodrigo Hasbun  5 , Eric L Brown  2 , Kristy O Murray  1
Affiliations

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

Timothy A Erickson et al. Microorganisms. .

Abstract

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 <90 days of age with meningitis at Texas Children's Hospital from 2010-2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis.

Results: Among 694 infants with meningitis, the most common etiology was viral (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.

Keywords: antibiotic resistance; enterovirus; epidemiology; etiologic diagnosis; group B Streptococcus; meningitis; neonatal infections.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Selection flowchart.
Figure 2
Figure 2
Enteroviral meningitis by year.
Figure 3
Figure 3
Bacterial meningitis and resistance patterns by year.
Figure 4
Figure 4
Meningitis cause by race.
See this image and copyright information in PMC

References

    1. Hasbun R., Wootton S.H., Rosenthal N., Balada-Llasat J.M., Chung J., Duff S., Bozzette S., Zimmer L., Ginocchio C.C. Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011–2014. Pediatr. Infect. Dis. J. 2019;38:37–41. doi: 10.1097/INF.0000000000002081. - DOI - PubMed
    1. Cherry J.D., Demmler-Harrison G., Kaplan S.L., Steinbach W.J., Hotez P.J. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 7th ed. Saunders/Elsevier; Philadelphia, PA, USA: 2014.
    1. Rotbart H.A. Enteroviral Infections of the Central Nervous System. Clin. Infect. Dis. 1995;20:971–981. doi: 10.1093/clinids/20.4.971. - DOI - PubMed
    1. Lee B.E., Dele Davies H. Aseptic meningitis. Curr. Opin. Infect. Dis. 2007;20:272–277. doi: 10.1097/QCO.0b013e3280ad4672. - DOI - PubMed
    1. Murphy T.V., White K.E., Pastor P., Gabriel L., Medley F., Granoff D.M., Osterholm M.T. Declining incidence of Haemophilus influenzae type b disease since introduction of vaccination. JAMA. 1993;269:246–248. doi: 10.1001/jama.1993.03500020080036. - DOI - PubMed

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