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. 2005 Jul;90(4):F324–F327. doi: 10.1136/adc.2004.066134

Early onset neonatal meningitis in Australia and New Zealand, 1992–2002

M May, A Daley, S Donath, D Isaacs, b on
PMCID: PMC1721922  PMID: 15878934

Abstract

Objectives: To study the epidemiology of early onset neonatal bacterial meningitis (EONBM) in Australasia.

Design: Prospective surveillance study, 1992–2002, in 20 neonatal units in Australia and New Zealand. EONBM was defined as meningitis occurring within 48 hours of delivery.

Results: There were 852 babies with early onset sepsis, of whom 78 (9.2%) had EONBM. The incidence of early onset group B streptococcal meningitis fell significantly from a peak of 0.24/1000 live births in 1993 to 0.03/1000 in 2002 (p trend = 0.002). There was no significant change over time in the incidence of Escherichia coli meningitis. The rate of EONBM in very low birthweight babies was 1.09/1000 compared with the rate in all infants of 0.11/1000. The overall rate of EONBM was 0.41/1000 in 1992 and 0.06 in 2001, but this trend was not significant (p trend = 0.07). Case-fatality rates for EONBM did not change significantly with time. Birth weight <1500 g (odds ratio (OR) 7.2 (95% confidence interval (CI) 4.8 to 10.9)) and Gram negative bacillary meningitis (OR 3.3 (95% CI 2.2 to 4.9)) were significant risk factors for mortality. Sixty two percent of the 129 babies who died from early onset sepsis or suspected sepsis did not have a lumbar puncture performed.

Conclusion: The incidence of early onset group B streptococcal meningitis has fallen, probably because of maternal intrapartum antibiotic prophylaxis, without a corresponding change in E coli meningitis. Gram negative bacillary meningitis still carries a worse prognosis than meningitis with a Gram positive organism.

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Selected References

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  1. Baltimore R. S., Huie S. M., Meek J. I., Schuchat A., O'Brien K. L. Early-onset neonatal sepsis in the era of group B streptococcal prevention. Pediatrics. 2001 Nov;108(5):1094–1098. doi: 10.1542/peds.108.5.1094. [DOI] [PubMed] [Google Scholar]
  2. Daley Andrew J., Isaacs David, Australasian Study Group for Neonatal Infections Ten-year study on the effect of intrapartum antibiotic prophylaxis on early onset group B streptococcal and Escherichia coli neonatal sepsis in Australasia. Pediatr Infect Dis J. 2004 Jul;23(7):630–634. doi: 10.1097/01.inf.0000128782.20060.79. [DOI] [PubMed] [Google Scholar]
  3. Doctor B. A., Newman N., Minich N. M., Taylor H. G., Fanaroff A. A., Hack M. Clinical outcomes of neonatal meningitis in very-low birth-weight infants. Clin Pediatr (Phila) 2001 Sep;40(9):473–480. doi: 10.1177/000992280104000901. [DOI] [PubMed] [Google Scholar]
  4. Francis B. M., Gilbert G. L. Survey of neonatal meningitis in Australia: 1987-1989. Med J Aust. 1992 Feb 17;156(4):240–243. doi: 10.5694/j.1326-5377.1992.tb139741.x. [DOI] [PubMed] [Google Scholar]
  5. Franco S. M., Cornelius V. E., Andrews B. F. Long-term outcome of neonatal meningitis. Am J Dis Child. 1992 May;146(5):567–571. doi: 10.1001/archpedi.1992.02160170047014. [DOI] [PubMed] [Google Scholar]
  6. Hervas J. A., Ballesteros F., Alomar A., Gil J., Benedi V. J., Alberti S. Increase of Enterobacter in neonatal sepsis: a twenty-two-year study. Pediatr Infect Dis J. 2001 Feb;20(2):134–140. doi: 10.1097/00006454-200102000-00003. [DOI] [PubMed] [Google Scholar]
  7. Hristeva L., Booy R., Bowler I., Wilkinson A. R. Prospective surveillance of neonatal meningitis. Arch Dis Child. 1993 Jul;69(1 Spec No):14–18. doi: 10.1136/adc.69.1_spec_no.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hyde Terri B., Hilger Tami M., Reingold Arthur, Farley Monica M., O'Brien Katherine L., Schuchat Anne, Active Bacterial Core surveillance (ABCs) of the Emerging Infections Program Network Trends in incidence and antimicrobial resistance of early-onset sepsis: population-based surveillance in San Francisco and Atlanta. Pediatrics. 2002 Oct;110(4):690–695. doi: 10.1542/peds.110.4.690. [DOI] [PubMed] [Google Scholar]
  9. Isaacs D., Barfield C. P., Grimwood K., McPhee A. J., Minutillo C., Tudehope D. I. Systemic bacterial and fungal infections in infants in Australian neonatal units. Australian Study Group for Neonatal Infections. Med J Aust. 1995 Feb 20;162(4):198–201. doi: 10.5694/j.1326-5377.1995.tb126024.x. [DOI] [PubMed] [Google Scholar]
  10. Isaacs D., Royle J. A. Intrapartum antibiotics and early onset neonatal sepsis caused by group B Streptococcus and by other organisms in Australia. Australasian Study Group for Neonatal Infections. Pediatr Infect Dis J. 1999 Jun;18(6):524–528. doi: 10.1097/00006454-199906000-00009. [DOI] [PubMed] [Google Scholar]
  11. Stoll Barbara J., Hansen Nellie, Fanaroff Avroy A., Wright Linda L., Carlo Waldemar A., Ehrenkranz Richard A., Lemons James A., Donovan Edward F., Stark Ann R., Tyson Jon E. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med. 2002 Jul 25;347(4):240–247. doi: 10.1056/NEJMoa012657. [DOI] [PubMed] [Google Scholar]
  12. Synnott M. B., Morse D. L., Hall S. M. Neonatal meningitis in England and Wales: a review of routine national data. Arch Dis Child. 1994 Sep;71(2):F75–F80. doi: 10.1136/fn.71.2.f75. [DOI] [PMC free article] [PubMed] [Google Scholar]

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