Epidemiology of Cerebrospinal Fluid Cultures and Time to Detection in Term Infants
| Autor: | Natasha Erickson, James F. Paulson, Rianna C. Leazer, Monica Stemmle, Alan R. Schroeder, Michael Bendel-Stenzel, Bryan R. Fine, Ronen Zipkin |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty Time Factors Population Bacteremia medicine.disease_cause Spinal Puncture Pneumococcal Infections Meningitis Bacterial Streptococcus agalactiae 03 medical and health sciences 0302 clinical medicine Streptococcal Infections 030225 pediatrics Internal medicine Streptococcus pneumoniae medicine Humans Blood culture 030212 general & internal medicine education Escherichia coli Infections Cerebrospinal Fluid Retrospective Studies education.field_of_study medicine.diagnostic_test Streptococcus Lumbar puncture business.industry Infant Newborn Infant medicine.disease United States Pneumococcal infections Pediatrics Perinatology and Child Health business Meningitis |
| Zdroj: | Pediatrics. 139 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2016-3268 |
| Popis: | BACKGROUND: Although meningitis is rare in previously healthy term infants, lumbar puncture is often performed to evaluate for source of illness. This study was performed to determine the time to detection for positive cerebrospinal fluid (CSF) cultures and to provide an update on the current epidemiology of bacterial meningitis in term infants. METHODS: This study was a multicenter, retrospective review of positive CSF cultures in infants ≤90 days of age. Specimens were drawn in the emergency department or inpatient setting between January 2000 and December 2013. Cultures were deemed true pathogens or contaminant species based on the attending physician’s treatment plan. Cultures from premature infants, an operative source, or those with significant medical history were excluded. RESULTS: A total of 410 positive CSF culture results were included, with 53 (12.9%) true pathogens and 357 (87.1%) contaminant species. The mean ± SD time to detection for true pathogens was 28.6 ± 16.8 hours (95% confidence interval, 24–33.2); for contaminant species, it was 68.1 ± 36.2 hours (95% confidence interval, 64.3–71.9). Forty-three true-positive cases (81.1%) were positive in ≤36 hours. The most common pathogen was group B Streptococcus (51%), followed by Escherichia coli (13%) and Streptococcus pneumoniae (9%). CONCLUSIONS: The majority of pathogenic bacteria in CSF exhibit growth within 36 hours. Most growth from CSF cultures in febrile infants is treated as contamination. The epidemiology of meningitis has remained constant, with group B Streptococcus as the predominant pathogen, despite changes noted in the epidemiology of bacteremia in this population. |
| Databáze: | OpenAIRE |
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