Department of Pediatrics, Duke University, Durham, NC, USA.
Duke Clinical Research Institute, Durham, NC, USA.
J Perinatol. 2024 Dec;44(12):1822-1826. doi: 10.1038/s41372-024-02069-0. Epub 2024 Jul 26.
Examine pathogen distribution, antibiotic resistance patterns, and hospital outcomes of infants with bacterial meningitis in neonatal intensive care units (NICUs) in the US from 2013-2018.
Infants were divided into 2 groups based on age at the time of meningitis: early-onset (0-3 days) and late-onset (>3 days). We compared demographics, clinical characteristics, epidemiology, hospital outcomes, distribution of organisms and resistance, and blood culture timing relative to cerebrospinal fluid culture.
From 345 NICUs, 659 infants were diagnosed with bacterial meningitis. The cumulative incidence was 1.1-1.3 cases/1000 NICU discharges. Median gestational age was 33 weeks, median birth weight was 1910 grams, 12% failed hearing screening, and 9% died prior to discharge. Of 141 cases of E. coli meningitis, 53% were resistant to ampicillin.
Significant morbidities occur in infants with culture-proven meningitis in NICUs. Culture and subsequent discernment of sensitivity are crucial to guide definitive therapy.
研究美国新生儿重症监护病房（NICU）中 2013 至 2018 年间婴儿细菌性脑膜炎的病原体分布、抗生素耐药模式和住院结局。
根据脑膜炎发生时的年龄，将婴儿分为两组：早发型（0-3 天）和晚发型（>3 天）。我们比较了人口统计学、临床特征、流行病学、住院结局、病原体分布和耐药性，以及血培养相对于脑脊液培养的时间。
从 345 家 NICU 中，共诊断出 659 例细菌性脑膜炎婴儿。累积发病率为每 1000 例 NICU 出院婴儿中有 1.1-1.3 例。中位胎龄为 33 周，中位出生体重为 1910 克，12%的婴儿未通过听力筛查，9%的婴儿在出院前死亡。在 141 例大肠杆菌脑膜炎中，有 53%对氨苄西林耐药。
在 NICU 中，确诊为细菌性脑膜炎的婴儿存在严重的发病情况。培养和随后的药敏分析对于指导明确的治疗至关重要。
