Clinical characteristics and etiology of bacterial meningitis in Chinese children &gt;28 days of age, January 2014–December 2016: A multicenter retrospective study

Chi, Li; Feng, Wenya; Lin, Aiwei; Guo, Zheng; Wang, Yanchun; Han, Yang; Zhong, Jia‐Yu; Bi, Jianzhong; Luo, Qiong; Zhao, Fang-chao; Jin, Peng; Guo, Lingyun; Li, Na; Yu, Jie; Yang, Xingliang; Liang, Jun; Deng, Jikui; Li, Yongjun; Wang, Yujiao; Yu, Xiongying; Wang, Dongmeng; Ru, Liang; Chen, Juan; Yang, Yonghong; Yang, Qiaozhi; Liu, Gang

doi:10.1016/j.ijid.2018.06.023

Cited by 33 publications

(43 citation statements)

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“…Bacterial meningitis remains a serious threat to children's health worldwide despite signi cant progress in the diagnosis and treatment of the disease. Of the 1142 patients in our study, 65.9% (753) were less than 1 year old, and over two-fths (513, 44.9%) were younger than 3 months, which was consistent with some previous studies [13,18]. These results indicated that most BM cases occurred in infants.…”

Section: Discussionsupporting

confidence: 91%

“…One study from the southwest provinces of China reported that approximately 46% of PBM cases were caused by Escherichia coli (E. coli) and S. pneumoniae from 2012 to 2015 [11]. The etiology of PBM varies greatly based on several factors, including geographical location, time, and age of the patients [8,[11][12][13]. In addition to their isolation rates, their AMR patterns vary substantially [14].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and antibiotic resistance of bacteria isolated from cerebrospinal fluid among children with bacterial meningitis in China from 2016 to 2018: A multicenter retrospective study

Peng

Zhu

Liu

et al. 2020

Preprint

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Background: Bacterial meningitis (BM) remains a devastating disease in children, and it causes substantial neurological morbidity and mortality worldwide. However, there are few large-scale studies on the pathogens causing pediatric bacterial meningitis (PBM) and their antimicrobial resistance (AMR) patterns in China. The present multicenter survey summarized the features of the etiologies of BM in children and characterized their AMR patterns.Methods: Data from 1193 cerebrospinal ﬂuid bacterial isolates from children with BM who were admitted to 13 children’s hospitals in China from 2016 to 2018 were analyzed retrospectively.Results: Of the 1142 patients with PBM, 65.9% (753) were less than 1 year old, and more than two-fifths (513, 44.9%) were younger than 3 months. The three leading pathogens causing PBM were Staphylococcus epidermidis (S. epidermidis) (16.5%), Escherichia coli (E. coli) (12.4%) and Streptococcus pneumoniae (S. pneumoniae) (10.6%). Infants under 3 months of age were at a relatively high risk of infection by E. coli (116/523; 22.2%), Enterococcus faecium (75/523; 14.3%), S. epidermidis (57/523; 10.9%), and Group B Streptococcus (55/523, 10.5%). However, Children more than 3 months of age were at a relatively high risk of infection by S. epidermidis (140/670; 20.9%), S. pneumoniae (117/670; 17.5%), and Staphylococcus hominis (57/670; 8.5%). Greater than 93.0% of E. coli isolates were sensitive to cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, amikacin and carbapenems, and the resistance rates to ceftriaxone, cefotaxime and ceftazidime were 49.4%, 49.2% and 26.4%, respectively. From 2016 to 2018, the proportion of methicillin-resistant coagulase-negative Staphylococcus (MRCoNS) isolates declined from 80.5% to 72.3%, and the frequency of penicillin-resistant Streptococcus pneumoniae (PRSP) isolates increased from 75.0% to 87.5%. The proportion of extended-spectrum β-lactamase (ESBL)-producing E. coli fluctuated between 44.4% and 49.2%, and the detection rate of ESBL production in Klebsiella pneumoniae (K. pneumoniae) ranged from 55.6% to 88.9%. The resistance of E. coli strains to carbapenems was 5.0%, but the overall prevalence of carbapenem-resistant (CR) K. pneumoniae was high (54.5%).Conclusions: The resistance of CoNS to methicillin and the high incidence of ESBL production in Gram-negative Enterobacteriaceae pose a critical challenge to infection control. Carbapenem-resistant K. pneumoniae isolates are a serious issue for the treatment of children with PBM.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Prevalence and antibiotic resistance of bacteria isolated from cerebrospinal fluid among children with bacterial meningitis in China from 2016 to 2018: A multicenter retrospective study

Peng

Zhu

Liu

et al. 2020

Preprint

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“…On the other hand more than half of E. coli (60%) was resistant to penicillin G in this study, which in line with study conducted in china which showed more than half of E. coli showed resistance to penicillin (42). In the present study E. coli showed the highest resistance to penicillin G (60%) followed by H. influenzae b (50%) and S. pneumoniae (38.5%).…”

Section: Discussionsupporting

confidence: 89%

Bacterial isolates from CSF sample and their antimicrobial resistance patters in among under-five children suspected for meningitis in Dilla University Referral Hospital

Awulachew

Diriba

Awoke

2020

Preprint

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Introduction: Bacterial meningitis is medical emergency that requires immediate medical attention. It is a cause of an estimated 288, 649 deaths worldwide per year, of which 94 883 death occur among Under-five children. Up to 24% of the survivors suffer from long-term sequelae such as epilepsy, mental retardation, or sensorineural deafness especially when the disease is contracted during early childhood.Objective: the aim of this study was to assess bacterial isolates of CSF sample and their antimicrobial resistance patterns among under-five children in Dilla University Referral Hospital. Material and Methods:Hospital based cross-sectional study design was used to collect clinical data and CSF sample from under-five children who was suspected for meningitis. Sediment of CSF sample was inoculated to Blood Agar plate, Chocolate Agar plate and Mackonkey Agar for bacterial isolation and identification. Chemical analysis and cytological analysis was also conducted based on standard operating procedures.Results: From a total of 287 CSF sample cultured, causative bacteria were detected in 38 (13.2%). From culture positive cases the most frequent isolate was Streptococcus pneumoniae 13 (34.2%) followed by Staphylococcus aureas 7 (18.4%), Neisseria meningitidis 6 (16%) and Escherichia coli 6 (16%). Haemophilus influenzae b was isolated in 4 (10.5%) of children with meningitis. The other cause of meningitis was Streptococcus agalactiae which accounted (10.5%). Cryptococcus neoformans have been detected in 4 (1.9%) cases of meningitis. Of all bacterial isolates about 42.1% (16/38) bacterial isolates were multidrug resistant. About 38.5% of S. pneumoniae was multidrug resistance while about 33.3% N. meningitis, 50% of H. influenzae, 57.1% of S. aureas and 40% of E. coli showed multidrug resistance Conclusions: High prevalence of bacterial meningitis and high rate of drug resistance were observed. S. pneumoniae was the leading cause of bacterial meningitis among under-five children.

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“…In two other hospitals in South China, GBS was the predominant pathogen associated with NS at 5.2–31.3%, which were higher values than those in middle China during the same period 7,9,23. Moreover, GBS (46.5%) was recently reported as the leading organism, followed by E. coli (23.3%) and S. aureus (7.0%), in infants <3 months old in a multicenter study on Chinese children diagnosed with bacterial meningitis between 28 days and 6 years of age, excluding neonates 24. GBS was the most common pathogen in both early-onset and late-onset bacterial meningitis.…”

Section: Discussionmentioning

confidence: 78%

<p>Incidence, Bacterial Profiles, And Antimicrobial Resistance Of Culture-Proven Neonatal Sepsis In South China</p>

Gao¹,

Fu²,

Guan³

et al. 2019

IDR

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BackgroundNeonatal sepsis (NS) is one of the leading causes of infant morbidity and mortality, but little is known about pathogen incidence and distribution in China.MethodsIn this retrospective study (January 2012 to December 2016), culture-proven cases aged less than 28 days with diagnosed NS in the Guangzhou Women and Children’s Medical Center, South China, were analyzed for pathogen incidence and antimicrobial resistance.ResultsA total of 620 isolates were identified from 597 NS cases. Gram-negative bacteria (n=371, 59.8%) dominated over Gram-positive bacteria (n=218, 35.2%) and fungi (n=30, 4.8%). Klebsiella pneumoniae (21.9%), Escherichia coli (21.9%), group B Streptococcus (GBS, 13.2%), and Staphylococcus aureus (6.8%) were the four most predominant pathogens. In early-onset sepsis (EOS), GBS (30.0%) and E. coli (20.0%) were dominant, whereas in late-onset sepsis (LOS), K. pneumoniae (25.6%) and E. coli (22.4%) were dominant. E. coli (25.2%) and GBS (17.7%) were the most frequently isolated from term patients, whereas K. pneumoniae was the most frequently isolated from preterm patients (34.9%). Of the infected infants, 9.5% died from sepsis, most commonly by E. coli infection (16.2%). Among 91,215 live births (LBs) delivered in the study hospital (2012–2016), 252 infants developed sepsis infection (2.76 per 1000 LBs, 95% CI 2.4–3.1), including EOS (0.78 per 1000 LBs) and LOS (2.13 per 1000 LBs). All GBS isolates were susceptible to β-lactam antibiotics, and S. aureus, including methicillin-resistant isolates, were susceptible to vancomycin. An extended-spectrum β-lactamase producer was identified in 37.3% of E. coli and 50.4% of K. pneumoniae.ConclusionK. pneumoniae was the most frequent pathogen in culture-proven NS in South China, primarily associated with LOS in preterm, whereas GBS was the dominant pathogen in EOS. E. coli was common in both episodes with the highest mortality.

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Clinical characteristics and etiology of bacterial meningitis in Chinese children >28 days of age, January 2014–December 2016: A multicenter retrospective study

Abstract: The occurrence of BM peaked in the first year of life, while S. pneumoniae was the predominant pathogen in children >3months of old. The antibiotic resistance of S. pneumoniae was a concern.

Cited by 33 publications

References 21 publications

Prevalence and antibiotic resistance of bacteria isolated from cerebrospinal fluid among children with bacterial meningitis in China from 2016 to 2018: A multicenter retrospective study

Prevalence and antibiotic resistance of bacteria isolated from cerebrospinal fluid among children with bacterial meningitis in China from 2016 to 2018: A multicenter retrospective study

Bacterial isolates from CSF sample and their antimicrobial resistance patters in among under-five children suspected for meningitis in Dilla University Referral Hospital

<p>Incidence, Bacterial Profiles, And Antimicrobial Resistance Of Culture-Proven Neonatal Sepsis In South China</p>

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