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

Samia Aleem; Daniel K Benjamin Jr; Charles M Burns; Jacob Duncan; Kalkidan Melaku; Abdulaziz Norbekov; Bethany Graham; Sriya Mantena; Tomi Ladipo; Ayan Jung; Kanecia O Zimmerman; Reese H Clark; Rachel G Greenberg

doi:10.1038/s41372-024-02069-0

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

J Perinatol. 2024 Jul 26. doi: 10.1038/s41372-024-02069-0. Online ahead of print.

Authors

Samia Aleem¹, Daniel K Benjamin Jr^{2

3}, Charles M Burns⁴, Jacob Duncan⁵, Kalkidan Melaku⁵, Abdulaziz Norbekov⁵, Bethany Graham⁵, Sriya Mantena⁵, Tomi Ladipo⁵, Ayan Jung⁶, Kanecia O Zimmerman^{1

5}, Reese H Clark⁷, Rachel G Greenberg^{8

9}

Affiliations

¹ Department of Pediatrics, Duke University, Durham, NC, USA.
² Department of Pediatrics, Duke University, Durham, NC, USA. [email protected].
³ Duke Clinical Research Institute, Durham, NC, USA. [email protected].
⁴ Department of Medicine, Duke University, Durham, NC, USA.
⁵ Duke Clinical Research Institute, Durham, NC, USA.
⁶ Cary Academy, Cary, NC, USA.
⁷ Pediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA.
⁸ Department of Pediatrics, Duke University, Durham, NC, USA. [email protected].
⁹ Duke Clinical Research Institute, Durham, NC, USA. [email protected].

PMID: 39060554
DOI: 10.1038/s41372-024-02069-0

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.