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Article

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

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Department of Pediatrics, Section of Pediatric Tropical Medicine, William T. Shearer Center for Human Immunobiology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USA
2
School of Public Health, University of Texas Health Science Center, Houston, TX 77030, USA
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Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX 77030, USA
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Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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McGovern Medical School, University of Texas, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Academic Editor: James Stuart
Microorganisms 2021, 9(3), 526; https://doi.org/10.3390/microorganisms9030526
Received: 15 January 2021 / Revised: 8 February 2021 / Accepted: 9 February 2021 / Published: 4 March 2021
(This article belongs to the Special Issue Bacterial Meningitis: Epidemiology and Vaccination)
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. View Full-Text
Keywords: neonatal infections; meningitis; epidemiology; antibiotic resistance; etiologic diagnosis; enterovirus; group B Streptococcus neonatal infections; meningitis; epidemiology; antibiotic resistance; etiologic diagnosis; enterovirus; group B Streptococcus
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MDPI and ACS Style

Erickson, T.A.; Munoz, F.M.; Troisi, C.L.; Nolan, M.S.; Hasbun, R.; Brown, E.L.; Murray, K.O. The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital. Microorganisms 2021, 9, 526. https://doi.org/10.3390/microorganisms9030526

AMA Style

Erickson TA, Munoz FM, Troisi CL, Nolan MS, Hasbun R, Brown EL, Murray KO. The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital. Microorganisms. 2021; 9(3):526. https://doi.org/10.3390/microorganisms9030526

Chicago/Turabian Style

Erickson, Timothy A., Flor M. Munoz, Catherine L. Troisi, Melissa S. Nolan, Rodrigo Hasbun, Eric L. Brown, and Kristy O. Murray 2021. "The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital" Microorganisms 9, no. 3: 526. https://doi.org/10.3390/microorganisms9030526

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