Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study

Background: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a retrospe...

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Main Authors: Martina Buttera, Sofia Mazzotti, Tommaso Zini, Lucia Corso, Valeria Dallai, Francesca Miselli, Luca Bedetti, Katia Rossi, Eugenio Spaggiari, Lorenzo Iughetti, Licia Lugli, Alberto Berardi
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/11/12/1411
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author Martina Buttera
Sofia Mazzotti
Tommaso Zini
Lucia Corso
Valeria Dallai
Francesca Miselli
Luca Bedetti
Katia Rossi
Eugenio Spaggiari
Lorenzo Iughetti
Licia Lugli
Alberto Berardi
author_facet Martina Buttera
Sofia Mazzotti
Tommaso Zini
Lucia Corso
Valeria Dallai
Francesca Miselli
Luca Bedetti
Katia Rossi
Eugenio Spaggiari
Lorenzo Iughetti
Licia Lugli
Alberto Berardi
author_sort Martina Buttera
collection DOAJ
description Background: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a retrospective analysis of infants of any gestational age with BM within their first 90 days of life and admitted to the Neonatal Intensive Care Unit of Modena Policlinico between 1 January 2011, and 31 December 2023. Results: A total of 44 episodes of meningitis were confirmed in 40 infants, diagnosed by positive cerebrospinal fluid cultures (<i>n</i> = 37), polymerase chain reaction testing (<i>n</i> = 4), or both methods (<i>n</i> = 3). Three out of forty infants (8%) experienced a relapse of meningitis. Most episodes (31/44, 70%) occurred in preterm infants. The incidence of early-onset meningitis was lower than that of late-onset (0.18 vs. 0.94 cases per 1000 births, respectively), with Gram-positive accounting for most cases (27/44, 61%). LP was performed prior to antibiotic administration in most episodes (30/44, 68%). Two preterm infants (5%) died from meningitis-related complications. Forty-two episodes occurred among thirty-eight surviving infants; brain lesions were detected through brain ultrasound or MRI in nine out of forty-two episodes (21%). Conclusions: Preterm infants have higher rates of BM, brain lesions or case fatalities. Early diagnosis and prompt antibiotic treatment are critical to improve outcomes.
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spelling doaj-art-6f41f6e930294910bbf6992ba9a607c52024-12-27T14:17:38ZengMDPI AGChildren2227-90672024-11-011112141110.3390/children11121411Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center StudyMartina Buttera0Sofia Mazzotti1Tommaso Zini2Lucia Corso3Valeria Dallai4Francesca Miselli5Luca Bedetti6Katia Rossi7Eugenio Spaggiari8Lorenzo Iughetti9Licia Lugli10Alberto Berardi11School of Pediatrics Residency, University of Modena and Reggio Emilia, 41224 Modena, ItalySchool of Pediatrics Residency, University of Modena and Reggio Emilia, 41224 Modena, ItalyPediatric Unit, Arcispedale Santa Maria Nuova, University of Modena and Reggio Emilia, 41224 Modena, ItalySchool of Pediatrics Residency, University of Modena and Reggio Emilia, 41224 Modena, ItalyDegree Program in Medicine and Surgery, University of Modena and Reggio Emilia, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalySchool of Pediatrics Residency, University of Modena and Reggio Emilia, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41224 Modena, ItalyBackground: Bacterial meningitis (BM) in infants is a serious condition that can lead to significant complications. Lumbar puncture (LP) is essential to provide diagnoses, however false negatives may result if LP is performed after the starting of antibiotic therapy. Methods: We conducted a retrospective analysis of infants of any gestational age with BM within their first 90 days of life and admitted to the Neonatal Intensive Care Unit of Modena Policlinico between 1 January 2011, and 31 December 2023. Results: A total of 44 episodes of meningitis were confirmed in 40 infants, diagnosed by positive cerebrospinal fluid cultures (<i>n</i> = 37), polymerase chain reaction testing (<i>n</i> = 4), or both methods (<i>n</i> = 3). Three out of forty infants (8%) experienced a relapse of meningitis. Most episodes (31/44, 70%) occurred in preterm infants. The incidence of early-onset meningitis was lower than that of late-onset (0.18 vs. 0.94 cases per 1000 births, respectively), with Gram-positive accounting for most cases (27/44, 61%). LP was performed prior to antibiotic administration in most episodes (30/44, 68%). Two preterm infants (5%) died from meningitis-related complications. Forty-two episodes occurred among thirty-eight surviving infants; brain lesions were detected through brain ultrasound or MRI in nine out of forty-two episodes (21%). Conclusions: Preterm infants have higher rates of BM, brain lesions or case fatalities. Early diagnosis and prompt antibiotic treatment are critical to improve outcomes.https://www.mdpi.com/2227-9067/11/12/1411meningitisbacterial meningitisneonatal infection
spellingShingle Martina Buttera
Sofia Mazzotti
Tommaso Zini
Lucia Corso
Valeria Dallai
Francesca Miselli
Luca Bedetti
Katia Rossi
Eugenio Spaggiari
Lorenzo Iughetti
Licia Lugli
Alberto Berardi
Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
Children
meningitis
bacterial meningitis
neonatal infection
title Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
title_full Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
title_fullStr Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
title_full_unstemmed Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
title_short Bacterial Meningitis in Infants Under 90 Days of Age: A Retrospective Single-Center Study
title_sort bacterial meningitis in infants under 90 days of age a retrospective single center study
topic meningitis
bacterial meningitis
neonatal infection
url https://www.mdpi.com/2227-9067/11/12/1411
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