Epidemiology and outcomes of bacterial meningitis in the neonatal intensive care unit

J Perinatol. 2024 Dec;44(12):1822-1826. doi: 10.1038/s41372-024-02069-0. Epub 2024 Jul 26.

Abstract

Objective: 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.

Study design: 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.

Results: 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.

Conclusions: Significant morbidities occur in infants with culture-proven meningitis in NICUs. Culture and subsequent discernment of sensitivity are crucial to guide definitive therapy.

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Drug Resistance, Bacterial
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Male
  • Meningitis, Bacterial* / diagnosis
  • Meningitis, Bacterial* / drug therapy
  • Meningitis, Bacterial* / epidemiology
  • Meningitis, Bacterial* / microbiology
  • Retrospective Studies
  • United States / epidemiology

Substances

  • Anti-Bacterial Agents