scholarly journals The Epidemiology of Meningitis in Infants under 90 Days of Age in a Large Pediatric Hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 526
Author(s):  
Timothy A. Erickson ◽  
Flor M. Munoz ◽  
Catherine L. Troisi ◽  
Melissa S. Nolan ◽  
Rodrigo Hasbun ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Bacterial Infections ◽  
Group B Streptococcus ◽  
Significant Risk ◽  
Viral Meningitis ◽  
Third Generation ◽  
Gram Negative ◽  
E Coli ◽  
Group B ◽  
Third Generation Cephalosporins

Background: Meningitis is associated with substantial morbidity and mortality, particularly in the first three months of life. Methods: We conducted a retrospective review of patients <90 days of age with meningitis at Texas Children’s Hospital from 2010–2017. Cases were confirmed using the National Healthcare Safety Network (NHSN) definition of meningitis. Results: Among 694 infants with meningitis, the most common etiology was viral (n = 351; 51%), primarily caused by enterovirus (n = 332; 95%). A quarter of cases were caused by bacterial infections (n = 190; 27%). The most common cause of bacterial meningitis was group B Streptococcus (GBS, n = 60; 32%), followed by Gram-negative rods other than E. coli (n = 40; 21%), and E. coli (n = 37; 19%). The majority of Gram-negative organisms (63%) were resistant to ampicillin, and nearly one-fourth of Gram-negative rods (23%) other than E. coli and 2 (6%) E. coli isolates were resistant to third-generation cephalosporins. Significant risk factors for bacterial meningitis were early preterm birth and the Black race. Conclusions: Enteroviruses most commonly caused viral meningitis in infants; GBS was the most common bacterial cause despite universal screening and intrapartum prophylaxis. The emergence of MRSA and resistance to third-generation cephalosporins in Gram-negative bacterial meningitis challenges the options for empirical antimicrobial therapy.

Childhood meningitis in the conjugate vaccine era: a prospective cohort study

2014 ◽  
Vol 100 (3) ◽  
pp. 292-294 ◽  
Author(s):  
Manish Sadarangani ◽  
Louise Willis ◽  
Seilesh Kadambari ◽  
Stuart Gormley ◽  
Zoe Young ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Group B Streptococcus ◽  
Bacterial Pathogen ◽  
Antibiotic Use ◽  
Viral Meningitis ◽  
Older Children ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Group B

Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK epidemiology is unknown. This prospective study recruited children under 16 years of age admitted to 3 UK hospitals with suspected meningitis. 70/388 children had meningitis—13 bacterial, 26 viral and 29 with no pathogen identified. Group B Streptococcus was the most common bacterial pathogen. Infants under 3 months of age with bacterial meningitis were more likely to have a reduced Glasgow Coma Score and respiratory distress than those with viral meningitis or other infections. There were no discriminatory clinical features in older children. Cerebrospinal fluid (CSF) white blood cell count and plasma C-reactive protein at all ages, and CSF protein in infants <3 months of age, distinguished between bacterial meningitis and viral meningitis or other infections. Improved diagnosis of non-bacterial meningitis is urgently needed to reduce antibiotic use and hospital stay.

scholarly journals Trends in Antibiotic Consumption and Resistance in France Over 20 Years: Large and Continuous Efforts but Contrasting Results

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Jean Carlet ◽  
Vincent Jarlier ◽  
Jacques Acar ◽  
Olivier Debaere ◽  
Patrick Dehaumont ◽  
...  
Keyword(s):  
Antibiotic Consumption ◽  
Third Generation ◽  
Antimicrobial Consumption ◽  
Information Campaign ◽  
Gram Negative ◽  
E Coli ◽  
Public Campaign ◽  
Third Generation Cephalosporins ◽  
Positive Effect ◽  
Gram Positive Cocci

Abstract Background Antimicrobial resistance (AMR) is a serious threat to humanity. This paper describes the French efforts made since 2001 and presents data on antimicrobial consumption (AC) and AMR. Methods We gathered all data on AC and AMR recorded since 2001 from different national agencies, transferred on a regular basis to standardized European data on AC and resistance in both humans and animals. Results After a large information campaign implemented in France from 2001 to 2005 in humans, AC in the community decreased significantly (18% to 34% according to the calculation method used). It remained at the same level from 2005 to 2010 and increased again from 2010 to 2018 (8%). Contrasting results were observed for AMR. The resistance of Staphylococcus aureus decreased significantly. For gram-negative bacilli, the results were variable according to the microorganism. The resistance of Enterobacteriaceae to third-generation cephalosporins increased, remaining moderate for Escherichia coli (12% in 2017) but reaching 35% in the same year for Klebsiella pneumoniae. Resistance to carbapenems in those 2 microorganisms remained below 1%. Both global AC and resistance to most antibiotics decreased significantly in animals. Conclusions Antibiotic consumption decreased significantly in France after a large public campaign from 2001 to 2005, but this positive effect was temporary. The effect on AMR varied according to the specific microorganism: The effect was very impressive for gram-positive cocci, variable for gram-negative bacilli, and moderate for E. coli, but that for K. pneumoniae was of concern. The consumption of and resistance to antibiotics decreased significantly in animals.

scholarly journals Detecting the dual presence of AmpC and ESBL enzymes

2009 ◽  
Vol 30 (5) ◽  
pp. 208
Author(s):  
John Sfakinos
Keyword(s):  
Generation Cephalosporin ◽  
Third Generation ◽  
Proteus Vulgaris ◽  
First Line ◽  
Morganella Morganii ◽  
Gram Negative ◽  
E Coli ◽  
Acinetobacter Spp ◽  
Gram Negative Organisms ◽  
Third Generation Cephalosporins

Inducible-chromosomal AmpC cephalosporinase enzymes have been recognised for several years in the ESCAPPM (Enterobacter spp., Serratia spp., Citrobacter freundii, Acinetobacter spp., Proteus vulgaris, Providencia spp. and Morganella morganii) group of gram-negative organisms, which result in the potential resistance to third-generation cephalosporin drugs. More recently several non-ESCAPPM Enterobacteriaceae (particularly E coli, Klebsiella and Proteus mirabilis) have been found to harbour a non-inducible-plasmid form of AmpC. This is particularly important when found in bacteremic patients where third-generation cephalosporins are often the first line drugs of choice.

scholarly journals CTX-M-type ESBL-mediated resistance to third-generation cephalosporins and conjugative transfer of resistance in Gram-negative bacteria isolated from hospitals in Tamil Nadu, India

2020 ◽  
Author(s):  
Ramesh Nachimuthu ◽  
Velu Rajesh Kannan ◽  
Bulent Bozdogan ◽  
Vaithilingam Krishnakumar ◽  
Karutha Pandian S ◽  
...  
Keyword(s):  
Type Species ◽  
Tamil Nadu ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Gram Negative ◽  
Content Type ◽  
E Coli ◽  
Link Type ◽  
Third Generation Cephalosporins ◽  
Group 1

Clinical pathogens, especially Gram-negative bacteria developing resistance to third-generation cephalosporins, are making clinical outcomes more complicated and serious. This study was undertaken to evaluate the distribution of CTX-M-type extended-spectrum β-lactamases (ESBLs) in Tamil Nadu, India. For this study, clinical samples were collected from five different hospitals located in Tamil Nadu and the ESBL-producing Gram-negative isolates were characterized. MIC was performed using cefotaxime and ceftazidime. The bla ESBL-producing genes were screened using multiplex PCR for the genes, CTX-M group-1, -2, -8, -9, -26. The conjugation studies were performed using Escherichia coli AB1157 as a recipient for the isolates harbouring plasmid-borne resistance following broth-mating experiment. In total, 1500 samples were collected and 599 Gram-negative bacteria were isolated that included E. coli (n=233), Klebsiella pneumoniae (n=182), Pseudomonas aeruginosa (n=79), Citrobacter spp. (n=30), Proteus mirabilis (n=28), Salmonella spp. (n=21), Acinetobacter baumannii (n=12), Serratia spp. (n=6), Shigella spp. (n=4), Morganella morganii (n=3) and Providencia spp. (n=1). MIC results showed that 358 isolates were resistant to cefotaxime and ceftazidime. Further, ESBL gene-amplification results showed that 19 isolates had CTX-M group-1 gene including E. coli (n=16), K. pneumoniae (n=2) and P. aeruginosa (n=1) whereas one M. morganii isolate had CTX-M group-9, which was plasmid-borne. Through conjugation studies, 12/20 isolates were found to be involved in the transformation of its plasmid-borne resistance gene. Our study highlighted the importance of horizontal gene transfer in the dissemination of plasmid-borne bla CTX-M-type resistance genes among the clinical isolates.

scholarly journals Extended Spectrum Beta-Lactamase (ESBL)-Mediated Resistance to Third Generation Cephalosporins and Conjugative Transfer of Resistance in Gram-Negative Bacteria Isolated from Hospitals in Tamil Nadu, India

2019 ◽  
Author(s):  
Nachimuthu Ramesh ◽  
Velu Rajesh Kannan ◽  
Bulent Bozdogan ◽  
Vaithilingam Krishnakumar ◽  
Prasanth Manohar
Keyword(s):  
Tamil Nadu ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Salmonella Spp ◽  
Gram Negative ◽  
E Coli ◽  
Extended Spectrum ◽  
Third Generation Cephalosporins ◽  
Group 1

Clinical pathogens especially Gram-negative bacteria developing resistance to third-generation cephalosporins are making the clinical outcome more complicated and serious. This study was undertaken to evaluate the distribution of extended-spectrum beta-lactamases in Tamil Nadu regions in India. For this study, clinical samples were collected from five different hospitals located in Tamil Nadu and ESBL producing Gram-negative isolates were characterized. Minimal inhibitory concentration (MIC) was performed using cefotaxime and ceftazidime. The blaESBL producing genes were screened using multiplex PCR for the genes, CTX-M group-1,-2,-8,-9,-26. Conjugation studies were performed using E. coli AB1157 as a recipient for the isolates harbouring plasmid-borne resistance following broth-mating experiment. In total, 1500 samples were collected and 599 Gram-negative bacteria were isolated that included Escherichia coli (n=233), Klebsiella pneumoniae (n=182), Pseudomonas aeruginosa (n=79), Citrobacter spp. (n=30), Proteus mirabilis (n=28), Salmonella spp. (n=21), Acinetobacter baumannii (n=12), Serratia spp. (n=6), Shigella spp. (n=4), Morganella morganii (n=3) and Providencia spp. (n=1). MIC results showed that 358 isolates were resistant to cefotaxime and ceftazidime. Further, ESBL gene amplification results showed that 19 isolates had CTX-M group-1 gene including E. coli (n=16), K. pneumoniae (n=2) and P. aeruginosa (n=1) whereas one M. morganii isolate had CTX-M group-9 gene in their plasmid. Through conjugation studies, 12/20 isolates were found to be involved in the transformation of its plasmid-borne resistance gene. Our study highlighted the role of horizontal gene transfer in the dissemination of plasmid-borne blaCTX-M resistance genes among ESBL producing isolates.

Treatment of Gram-Negative Bacterial Meningitis in Term Neonates with Third Generation Cephalosporins plus Amikacin

2000 ◽  
Vol 77 (3) ◽  
pp. 139-146 ◽  
Author(s):  
H.D. Dellagrammaticas ◽  
Ch. Christodoulou ◽  
E. Megaloyanni ◽  
M. Papadimitriou ◽  
J. Kapetanakis ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Third Generation ◽  
Term Neonates ◽  
Gram Negative ◽  
Third Generation Cephalosporins

STUDIES ON INTERACTION OF BACTERIA, SERUM FACTORS AND POLYMORPHONUCLEAR LEUKOCYTES IN MOTHERS AND NEWBORNS

PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 49-57 ◽  
Author(s):  
John H. Dossett ◽  
Ralph C. Williams ◽  
Paul G. Quie
Keyword(s):  
Polymorphonuclear Leukocytes ◽  
Bacterial Species ◽  
Group B Streptococcus ◽  
Newborn Infants ◽  
Maternal Serum ◽  
Humoral Factors ◽  
Serum Factors ◽  
E Coli ◽  
Serum Fractions ◽  
Group B

The bactericidal capacity of newborn infants' whole blood for E. coli was deficient compared to the mothers, and attempts were made to identify cellular or humoral factors responsible for this deficiency. Separated polymorphonuclear leukocytes from newborn infants were found to be similar to polymorphs from mothers in capacity to engulf and kill E. coli and other bacteria so that cellular deficiency was not evident. Comparison of the serum opsonic capacity of newborn infants' and mothers' sera revealed deficient opsonic capacity for E. coli in newborn sera. The mean opsonic titer for E. coli was 46.7 in mothers and 4.3 in neonates. Serum opsonic titers for Staph. aureus and group B streptococcus were similar. The opsonic capacity for all bacterial species was decreased when the sera were heated or decomplemented with immune complexes indicating the phagocytosis amplifying role of complement. The newborn-maternal difference in opsonic capacity for E. coli was presumably a result of deficient 19S antibodies, the primary opsonic antibodies for this organism. Maternal 19S serum fractions alone, however, showed no opsonic capacity for E. coli. Addition of a complement source (newborn serum absorbed with E. coli) revealed the opsonic capacity of these 19S maternal serum fractions for E. coli. Antibodies in 19S serum fractions therefore are efficient opsonins for E. coli; however, complement is necessary to demonstrate their opsonic potential.

▾ Temocillin injection for gram-negative infections only

1991 ◽  
Vol 29 (14) ◽  
pp. 55-56
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Third Generation ◽  
Gram Negative ◽  
Third Generation Cephalosporins

Temocillin (Temopen - SKB) is a penicillin which is β-lactamase-resistant and specifically effective against Gram-negative aerobic organisms. It is active against coliforms resistant to third generation cephalosporins but not against Pseudomonas aeruginosa.1

scholarly journals Clinical profile and outcome of pediatric bacterial meningitis: a prospective study from tertiary institute in Northern India

2018 ◽  
Vol 6 (8) ◽  
pp. 2739
Author(s):  
Ashok Garg ◽  
Ashish Sharma ◽  
Sandhya Kumari ◽  
Ambuj Shandil
Keyword(s):  
Bacterial Meningitis ◽  
Group B Streptococcus ◽  
Antibiotic Use ◽  
Latex Agglutination ◽  
High Rate ◽  
Acute Bacterial Meningitis ◽  
Age Group ◽  
Cell Counts ◽  
Acute Complications ◽  
Group B

Background: Meningitis is one of the fatal infections occurring in infants and older children. In acute bacterial meningitis (ABM), inflammation of the leptomeninges is triggered by bacteria present in the subarachnoid space. ABM is associated with a high rate of acute complications and long-term morbidity. Aim of our study was to determine the incidence, etiological profile and complications of acute bacterial meningitis amongst children belonging to one month to five years of age.Methods: The present study was conducted over a period of one year and diagnosis of meningitis was made on basis of history, examination and laboratory investigations. Clinical features were recorded on case sheet. Lumbar puncture was done, and CSF was sent for biochemical analysis, cell counts, staining, culture and latex agglutination test (LAT).Results: Out of total 1560 admitted cases (1 month to 5years age group), 160 cases were suspected with meningitis while 57 cases were confirmed to have ABM. Most (59.6%) cases belonged to 3 months to 1-year age group and males outnumbered the females by a ratio of 2:1. Group B Streptococcus (45.6%) was most common pathogen in 45.6% cases followed by Streptococcus pneumoniae (21%) and Hemophilus influenzae (10.52%). Seizures (45%) and increased ICP (28%) were main acute complications observed during hospitalization while hemiparesis 9.6%, monoparesis 4.8%, seizures 38%, vision and hearing deficits were the sequelae observed on follow up examination. These complications were predominantly contributed by S. pneumoniae and H. Influenzae.Conclusions: The incidence of ABM is still high and Group B streptococcus is main pathogen even in post neonatal period. The complications of ABM are markedly higher in cases of S. pneumoniae, H. Influenzae meningitis in comparison to Group B streptococcus meningitis. Formulating standard protocols for management of ABM and rational antibiotic use to prevent resistance is the need of hour.

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