Prevalence of Concomitant Acute Bacterial Meningitis in Neonates with Febrile Urinary Tract Infection: A Retrospective Cross-Sectional Study
| Autor: | Danielle Nicole Brown, Andrea T. Cruz, Sowdhamini S. Wallace |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Fever Meningitis Bacterial 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid 030225 pediatrics Internal medicine White blood cell Prevalence medicine Humans 030212 general & internal medicine Pleocytosis Retrospective Studies medicine.diagnostic_test Lumbar puncture business.industry Infant Newborn Meningoencephalitis Retrospective cohort study medicine.disease Surgery Cross-Sectional Studies medicine.anatomical_structure Bacteremia Acute Disease Urinary Tract Infections Pediatrics Perinatology and Child Health Female business Meningitis |
| Zdroj: | The Journal of Pediatrics. 184:199-203 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2017.01.022 |
| Popis: | Objective To describe the frequency of concomitant acute bacterial meningitis (ABM) in neonates with febrile urinary tract infection (UTI). Study design This was a retrospective cross-sectional study from 2005 to 2013 of infants ≤30 days old evaluated in the emergency department of a quaternary care children's hospital with fever and laboratory-confirmed UTI. Definite ABM was defined as cerebrospinal fluid (CSF) culture with growth of pathogenic bacteria and probable ABM if pleocytosis with ≥ 20 white blood cell was present in an antibiotic-pretreated patient. The timing of lumbar puncture and first antibiotic dose was recorded to assess for antibiotic pretreatment. Results A total of 236 neonates with UTI were included. Mean age was 18.6 days (SD 6.2); 79% were male infants. Twenty-three (9.7%) had bacteremia. Fourteen (6%) were pretreated. No neonate (0%; 95% CI 0%-1.6%) had definite ABM and 2 (0.8%; 95% CI 0.1%-3.0%) neonates with bloody CSF had probable ABM. CSF white blood cell count was 25 and 183 for these 2 infants, and CSF red blood cell count was 3100 and 61 932, respectively. Another neonate had herpes simplex virus meningoencephalitis. Conclusions The frequency of ABM in neonates with febrile UTI is low. Further prospective studies are needed to evaluate the safety of a tiered approach to evaluate for serious bacterial infection, in which lumbar puncture potentially could be avoided in well-appearing febrile neonates with suspected UTI. |
| Databáze: | OpenAIRE |
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