Comparison of cerebrospinal fluid in newborns and in infants ≤2 months old with or without meningitis

Eslami, Saeedeh Tarvij; Nassirian, Hossain; Mojgan, Bayat Mokhtary; Bahieh, Zarif Zakerian; Hatami, Elham; Alimohamad, Nassirian; Sobhani, Ehsan

doi:10.1111/j.1442-200x.2011.03551.x

Cited by 4 publications

(4 citation statements)

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“…Early recognition of meningitis infants at risk of poor prognosis would be helpful in providing prompt management and identifying those who warrant long-term follow-up and early intervention [ 23 – 25 ]. Previous studies showed a number of possible early markers of poor prognosis in neonatal meningitis.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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“…We retrieved 371 studies with 427 study periods performed from January 1, 1935, to December 31, 2019, in 108 countries, describing 157 656 episodes of community-acquired bacterial meningitis. 5, Of the 33 295 episodes for which the patients' sex was reported, 13 452 (40%) occurred in females ( 25,29,32,38,42,43,45,49,55,63,70,86,93,97,101,105,121,126,127,132,133,138,142,157,159,160,196,200,212,214,216,220,235,241,258,275,281,294,297,299,307,319,321,323,324,336,340,345,346,358,365,…”

Section: Resultsmentioning

confidence: 99%

“…The design was observational in 330 studies (94%) and interventional in 20 (6%) studies, with 12 to 22 831 (median [IQR], 115 [61-270]) episodes per study, and the inclusion period’s length varying from 3 months to 36 years (median [IQR], 5 [2-10] years). Studies included neonates (59 studies [16%]; 6549 episodes [4%]), children (101 studies [27%]; 21 511 episodes [14%]), adults (64 studies [17%]; 15 362 episodes [10%]), neonates and children (68 studies [18%]; 26 992 episodes [17%]),…”

Section: Resultsmentioning

confidence: 99%

“…The design was observational in 330 studies (94%) and interventional in 20 (6%) studies, with 12 to 22 831 (median [IQR], 115 [61-270]) episodes per study, and the inclusion period’s length varying from 3 months to 36 years (median [IQR], 5 [2-10] years). Studies included neonates (59 studies [16%]; 6549 episodes [4%]), 25 , 29 , 32 , 38 , 42 , 43 , 45 , 49 , 55 , 63 , 70 , 86 , 93 , 97 , 101 , 105 , 121 , 126 , 127 , 132 , 133 , 138 , 142 , 157 , 159 , 160 , 196 , 200 , 212 , 214 , 216 , 220 , 235 , 241 , 258 , 275 , 281 , 294 , 297 , 299 , 307 , 319 , 321 , 323 , 324 , 336 , 340 , 345 , 346 , 358 , 365 , 368 , 373 , 377 , 379 , 382 , ...…”

Section: Resultsmentioning

confidence: 99%

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Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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ImportanceThe impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain.ObjectiveTo describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis.Data SourcesGoogle Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality.Study SelectionIncluded studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care–associated meningitis, tuberculous meningitis, or missing outcome were excluded.Data Extraction and SynthesisData were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period’s year as an estimator variable were used.Main Outcome and MeasureCase fatality ratios of bacterial meningitis.ResultsThis review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients’ sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P &lt; .001).Conclusions and RelevanceIn this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

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Normal Values for Cerebrospinal Fluid in Neonates: A Systematic Review

Zimmermann

Curtis

2021

Neonatology

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Background: The diagnosis of neonatal meningitis often rests on microscopic and biochemical findings in the cerebrospinal fluid (CSF). There is ongoing uncertainty about age-related normal values for CSF findings in neonates, and many previous studies have included infants in whom antibiotics were administered before lumbar puncture or in whom viral meningitis was not excluded. Methods: A systematic search was done using MEDLINE and EMBASE to identify original studies which investigated CSF normal values in either healthy neonates or febrile neonates in whom bacterial and viral meningitis were reliably excluded. Results: We identified seven studies investigating 270 term and 96 preterm neonates. There were minimal differences between preterm and term neonates in the CSF white blood cell (WBC) count and glucose concentration. In contrast, the CSF neutrophil count and protein concentration were influenced by gestational and chronological age. In the four studies that reported individual patient data, in 95% of cases the CSF WBC count was <12 cells/μL in preterm and <10 cells/μL in term neonates, the neutrophil count was <16 and 8 cells/μL, and the protein concentration was <210 and 110 mg/dL, respectively. Conclusion: The normal range for CSF parameters in neonates is different to that in older infants, and some parameters are influenced by gestational and chronological age. CSF parameters alone are not sufficiently reliable to exclude meningitis.

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Comparison of cerebrospinal fluid in newborns and in infants ≤2 months old with or without meningitis

Cited by 4 publications

References 18 publications

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

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

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

Normal Values for Cerebrospinal Fluid in Neonates: A Systematic Review

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