From the Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Division of Neonatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Pediatr Infect Dis J. 2019 May;38(5):476-480. doi: 10.1097/INF.0000000000002247.
Meningitis is a serious disease that occurs more commonly in the neonatal period than in any other age group. Recent data from large national cohorts are needed to determine if the epidemiology of neonatal meningitis (NM) has changed.
To assess the rates, causative organisms, risk factors, temporal trends and short-term outcomes of NM in Canadian Neonatal Intensive Care Units (NICUs).
A retrospective review of newborn infants admitted to NICUs participating in the Canadian Neonatal Network between January 2010 and December 2016. Patients with meningitis were reviewed. Outcomes of patients with meningitis were compared with 1:2 matched (for gestation, sex and birth weight) neonates without meningitis.
Rates of NM ranged between 2.2 and 3.5/1000 NICU admissions during the 7-year study period with the majority of patients (87%) having late-onset meningitis (at >3 days after birth). The most common bacterial organism for both early- and late-onset meningitis was Escherichia coli followed by group B streptococci. Only 31% [95% confidence interval (CI): 24.06-38.63) of neonates with meningitis had simultaneous bacteremia. NM was associated with increased seizures [odds ratio (OR): 8.63; 95% CI: 4.73-15.7], retinopathy of prematurity (OR: 3.23; 95% CI: 1.30-8.02), bronchopulmonary dysplasia (OR: 1.93; 95% CI: 1.11-3.35), days of mechanical ventilation (OR: 1.03; 95% CI: 1.02-1.04) and length of hospital stay (OR: 1.02; 95% CI: 1.01-1.02), but not with mortality before discharge (OR: 1.29; 95% CI: 0.74-2.23).
The rate of NM remains largely unchanged in Canadian NICUs. NM was associated with increased major morbidities and longer hospital stay but not with mortality before discharge.
脑膜炎是一种比其他任何年龄段都更常见的严重疾病，发生在新生儿期。需要来自大型全国队列的数据来确定新生儿脑膜炎（NM）的流行病学是否发生了变化。
评估加拿大新生儿重症监护病房（NICU）中 NM 的发生率、病原体、危险因素、时间趋势和短期结局。
对 2010 年 1 月至 2016 年 12 月期间参加加拿大新生儿网络的 NICU 入院的新生儿进行回顾性审查。对患有脑膜炎的患者进行了回顾。将脑膜炎患者的结局与 1：2 匹配（胎龄、性别和出生体重）无脑膜炎的新生儿进行比较。
在 7 年的研究期间，NM 的发生率在 2.2 至 3.5/1000 NICU 入院之间，大多数患者（87%）患有晚发性脑膜炎（出生后>3 天）。早发性和晚发性脑膜炎最常见的细菌病原体均为大肠杆菌，其次为 B 群链球菌。只有 31%（95%置信区间[CI]：24.06-38.63）的脑膜炎新生儿同时患有菌血症。NM 与癫痫发作（比值比[OR]：8.63；95%CI：4.73-15.7）、早产儿视网膜病变（OR：3.23；95%CI：1.30-8.02）、支气管肺发育不良（OR：1.93；95%CI：1.11-3.35）、机械通气天数（OR：1.03；95%CI：1.02-1.04）和住院时间（OR：1.02；95%CI：1.01-1.02）有关，但与出院前死亡率无关（OR：1.29；95%CI：0.74-2.23）。
加拿大 NICU 中 NM 的发生率基本保持不变。NM 与更多的主要并发症和更长的住院时间有关，但与出院前死亡率无关。
