Document Detail


Neonatal bacterial meningitis.
MedLine Citation:
PMID:  21089719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neonatal bacterial meningitis (NM) continues to be a serious disease with an unchanging rate of adverse outcome of 20-60%, despite a worldwide decline in mortality. The 3 major pathogens in developed countries are: Group B streptococcus, gram negative rods and Lysteria monocytogenes. Signs and symptoms of NM may be subtle, unspecific, vague, atypical or absent. In order to exclude NM, all infants with proven or suspected sepsis should undergo lumbar puncture. Positive culture of cerebrospinal fluid may be the only way to diagnose NM and to identify the pathogen, as CSF parameters Smay be normal at early stages and NM may occur frequently (up to 30% of cases) in the absence of bacteraemia. When NM is suspected, treatment must be aggressive, as the goal is to achieve bactericidal concentration of antibiotics and to sterilize CSF as soon as possible. Antibiotics should be administered intravenously, at the highest clinically validated doses. Empiric antibiotic treatment should include agents active against all main pathogens; currently the recommended empiric treatment of NM is ampicillin, plus an aminoglycoside and a third-generation cephalosporn. Therapy should be reassessed after cultures and antibiotic susceptibility is available. Prevention of neonatal sepsis, early recognition of infants at risk, prompt treatment and future adjunctive therapies will improve prognosis. Finally, we present the first preliminary Italian data on GBS meningitis. Data are obtained from an area-based study conducted In Emilia-Romagna during 2003 to 2009.
Authors:
A Berardi; L Lugli; C Rossi; M C China; G Vellani; R Contiero; F Calanca; F Camerlo; F Casula; C Di Carlo; M R Rossi; R Chiarabini; M Ferrari; S Minniti; C Venturelli; D Silvestrini; I Dodi; A Zucchini; F Ferrari;
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva pediatrica     Volume:  62     ISSN:  0026-4946     ISO Abbreviation:  Minerva Pediatr.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400740     Medline TA:  Minerva Pediatr     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  51-4     Citation Subset:  IM    
Affiliation:
Terapia intensiva neonatale, Azienda Ospedaliera Policlinico, Modena.
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MeSH Terms
Descriptor/Qualifier:
Age of Onset
Anti-Bacterial Agents / administration & dosage,  therapeutic use
Cerebrospinal Fluid / microbiology
Humans
Infant, Newborn
Infant, Premature, Diseases / epidemiology
Italy / epidemiology
Meningitis, Bacterial* / cerebrospinal fluid,  diagnosis,  drug therapy,  epidemiology,  microbiology
Multicenter Studies as Topic / statistics & numerical data
Prospective Studies
Spinal Puncture
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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