Aspects cliniques et évolutifs des méningites bactériennes néonatales

Hamouda, H. Ben; Khalifa, A. Ben Haj; Hamza, M; Ayadi, A.; Soua, H.; Khedher, M.; Sfar, M.T.

doi:10.1016/j.arcped.2013.05.005

Cited by 22 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the day that this disease was discovered, corticosteroids, therapeutic hypothermia, monoclonal antibodies and other therapies have been used in addition to antibiotics an attempt to improve outcomes in bacterial meningitis ( 1 , 2 ). However, today, mortality and morbidity remain high (approximately 10–15% and 4/1000-5/1000 of live births, respectively) globally in neonates with bacterial meningitis ( 3 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

et al. 2018

View full text Add to dashboard Cite

Background: Neonatal bacterial meningitis is a severe infection with high mortality and morbidity. It is necessary to identify factors associated with a high risk of a poor prognosis so that we can prevent them with more appropriate treatments. This study was performed to summarize the prognostic factors known to predict adverse outcomes in neonatal bacterial meningitis.Methods: The Medline/PubMed, Cochrane Library and Embase databases were searched for studies of prognostic risk factors in neonates with bacterial meningitis. Studies published from the initiation of the database to April 30th, 2017 were included. The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) scale. Each prognostic factor known to cause adverse outcomes is summarized.Results: Sixteen studies were identified, including 7 cohort studies and 9 cross section studies. Seizure and high protein levels in the cerebrospinal fluid (CSF) predict a poor prognosis in this disease. Coma, the need for ventilation support, and leukopenia also had some value for predicting poor prognoses. A bulging anterior fontanelle was valuable for predicting mortality. Low CSF glucose levels, thrombocytopenia, gestational age (GA) < 37 weeks and an altered sensorium were correlated with a poor prognosis. A birth weight < 2500 g, early onset meningitis and positive CSF cultures were correlated with mortality.Conclusions: This study provides a preliminary exploration of prognostic factors in neonatal bacterial meningitis and thereby fills some of the gaps in the study of prognoses in this disease. These prognostic factors can be used to predict and estimate outcomes in neonatal bacterial meningitis. Without a meta-analysis, the reliability of these factors cannot be assured. In addition, these results emphasize that there is an urgent need for a standardized protocol for follow-up and well-designed prognostic studies in neonatal bacterial meningitis.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Neonatal bacterial meningitis (NBM) remains a devastating disease associated with high mortality and morbidity despite advanced antibiotic treatments [1,2]. Bacterial penetration through the blood-brain barrier (BBB) and polymorphonuclear neutrophil (PMN) recruitment to the central nervous system (CNS) often lead to serious neurological sequelae [3][4][5][6][7][8]. A better understanding of molecular and cellular mechanisms has important implications for preventing NBM and treating Escherichia coli K1.…”

mentioning

confidence: 99%

CD48 and α7 Nicotinic Acetylcholine Receptor Synergistically Regulate FimH-MediatedEscherichia coliK1 Penetration and Neutrophil Transmigration Across Human Brain Microvascular Endothelial Cells

Liu

et al. 2018

The Journal of Infectious Diseases

View full text Add to dashboard Cite

FimH-mediated bacterial invasion and polymorphonuclear neutrophil (PMN) transmigration across human brain microvascular endothelial cells (HBMEC) are required for the pathogenesis of Escherichia coli meningitis. However, the underlying mechanism remains unclear. This study demonstrated that the TnphoA mutant (22A33) and FimH-knockout mutant (ΔFimH )of Escherichia coli strain E44, which resulted in inactivation of FimH, were less invasive and less effective in promoting PMN transmigration than their wildtype strain. FimH protein induced PMN transmigration, while calmodulin inhibitor significantly blocked this effect. Moreover, immunofluorescence and co-immunoprecipitation analysis indicated that co-localized CD48 and α7 nAChR formed a complex on the surface of HBMEC that is associated with increased cofilin dephosphorylation, which could be remarkably enhanced by FimH+ E44. Our study concluded that FimH-induced E. coli K1 invasion and PMN migration across HBMEC may be mediated by the CD48-α7nAChR complex in lipid rafts of HBMEC via Ca2+ signaling and cofilin dephosphorylation.

show abstract

“…However, it had limited specificity in distinguishing from other severe diseases such as sepsis, meningitis, hypoxemia, or radiologically proven pneumonia. Ben et al found that respiratory distress was one of the main factors of a poor prognosis in neonatal bacterial meningitis [ 28 ]. We found that pneumonia was related to poor outcome in neonatal meningitis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Prognosis in Neonatal Bacterial Meningitis: The Role of Cerebrospinal Fluid Protein

et al. 2015

View full text Add to dashboard Cite

Neonates are at high risk of meningitis and of resulting neurologic complications. Early recognition of neonates at risk of poor prognosis would be helpful in providing timely management. From January 2008 to June 2014, we enrolled 232 term neonates with bacterial meningitis admitted to 3 neonatology departments in Shanghai, China. The clinical status on the day of discharge from these hospitals or at a postnatal age of 2.5 to 3 months was evaluated using the Glasgow Outcome Scale (GOS). Patients were classified into two outcome groups: good (167 cases, 72.0%, GOS = 5) or poor (65 cases, 28.0%, GOS = 1–4). Neonates with good outcome had less frequent apnea, drowsiness, poor feeding, bulging fontanelle, irritability and more severe jaundice compared to neonates with poor outcome. The good outcome group also had less pneumonia than the poor outcome group. Besides, there were statistically significant differences in hemoglobin, mean platelet volume, platelet distribution width, C-reaction protein, procalcitonin, cerebrospinal fluid (CSF) glucose and CSF protein. Multivariate logistic regression analyses suggested that poor feeding, pneumonia and CSF protein were the predictors of poor outcome. CSF protein content was significantly higher in patients with poor outcome. The best cut-offs for predicting poor outcome were 1,880 mg/L in CSF protein concentration (sensitivity 70.8%, specificity 86.2%). After 2 weeks of treatment, CSF protein remained higher in the poor outcome group. High CSF protein concentration may prognosticate poor outcome in neonates with bacterial meningitis.

show abstract

Aspects cliniques et évolutifs des méningites bactériennes néonatales

Cited by 22 publications

References 28 publications

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

Risk Factors in Predicting Prognosis of Neonatal Bacterial Meningitis—A Systematic Review

CD48 and α7 Nicotinic Acetylcholine Receptor Synergistically Regulate FimH-MediatedEscherichia coliK1 Penetration and Neutrophil Transmigration Across Human Brain Microvascular Endothelial Cells

Clinical Prognosis in Neonatal Bacterial Meningitis: The Role of Cerebrospinal Fluid Protein

Contact Info

Product

Resources

About