Lumbar Puncture and Meningitis in Infants with Proven Early- or Late-Onset Sepsis: An Italian Prospective Multicenter Observational Study

被引：7

作者：

Bedetti, Luca ^{[1
,2
]}

Miselli, Francesca ^{[1
,2
]}

Minotti, Chiara ^{[1
]}

Latorre, Giuseppe ^{[3
]}

Loprieno, Sabrina ^{[4
]}

Foglianese, Alessandra ^{[4
]}

Laforgia, Nicola ^{[4
]}

Perrone, Barbara ^{[5
]}

Ciccia, Matilde ^{[6
]}

Capretti, Maria Grazia ^{[7
]}

Giugno, Chiara ^{[8
]}

Rizzo, Vittoria ^{[9
]}

Merazzi, Daniele ^{[10
]}

Fanaro, Silvia ^{[11
]}

Taurino, Lucia ^{[12
]}

Pulvirenti, Rita Maria ^{[13
]}

Orlandini, Silvia ^{[14
]}

Auriti, Cinzia ^{[15
]}

Haass, Cristina ^{[16
]}

Ligi, Laura ^{[17
]}

Vellani, Giulia ^{[18
]}

Tzialla, Chryssoula ^{[19
]}

Tuoni, Cristina ^{[20
]}

Santori, Daniele ^{[21
]}

China, Mariachiara ^{[22
]}

Baroni, Lorenza ^{[23
]}

Nider, Silvia ^{[24
]}

Visintini, Federica ^{[25
]}

Decembrino, Lidia ^{[26
]}

Nicolini, Giangiacomo ^{[27
]}

Creti, Roberta ^{[28
]}

Pellacani, Elena ^{[29
]}

Dondi, Arianna ^{[30
]}

Lanari, Marcello ^{[30
]}

Benenati, Belinda ^{[31
]}

Biasucci, Giacomo ^{[31
]}

Gambini, Lucia ^{[32
]}

Lugli, Licia ^{[1
]}

Berardi, Alberto ^{[1
]}

机构：

[1] Univ Hosp Modena, Neonatal Intens Care Unit, I-41224 Modena, Italy

[2] Univ Modena & Reggio Emilia, PhD Program Clin & Expt Med, I-21124 Modena, Italy

[3] Ecclesiast Gen Hosp F Miulli, Neonatal Intens Care Unit, I-70021 Acquaviva Delle Fonti, Italy

[4] Univ Hosp Bari Aldo Moro, Dept Biomed Sci & Human Oncol DIMO, Neonatal Intens Care Unit, I-70124 Bari, Italy

[5] Azienda Osped Univ Marche, Neonatal Intens Care Unit, I-60126 Ancona, Italy

[6] Maggiore Hosp, Womens & Childrens Hlth Dept, Neonatal Intens Care Unit, I-40133 Bologna, Italy

[7] St Orsola Marcello Malpighi Hosp, Womens & Childrens Hlth Dept, Neonatal Intens Care Unit, I-40138 Bologna, Italy

[8] Osped B Ramazzini, Pediat Unit, I-41012 Carpi, Italy

[9] Bufalini Hosp, Neonatal Intens Care Unit, I-47521 Cesena, Italy

[10] Valduce Hosp, Div Neonatol, I-22100 Como, Italy

[11] Univ Hosp, Dept Med Sci, Pediat Sect, I-44124 Ferrara, Italy

[12] Osped Riuniti Foggia, Neonatal Intens Care Unit, I-71122 Foggia, Italy

[13] Morgagni Pierantoni Hosp Forli, Pediat & Neonatal Unit, I-47121 Forli, Italy

[14] Carlo Poma Hosp, Neonatal Intens Care Unit, I-46100 Mantua, Italy

[15] Bambino Gesu Childrens Hosp IRCCS, Med & Surg Dept Fetus Newborn Infant, Neonatal Intens Care Unit, I-00165 Rome, Italy

[16] San Pietro Fatebenefratelli Hosp, Neonatal Intens Unit, I-00168 Rome, Italy

[17] San Filippo Neri Hosp, Neonatal Intens Unit, I-00135 Rome, Italy

[18] ARNAS Civ Cristina Benfratelli, Neonatal Intens Unit, I-90127 Palermo, Italy

[19] ASST Pavia, Neonatal & Pediat Unit, Polo Osped Oltrepo, I-27100 Pavia, Italy

[20] Univ Hosp Pisa, Dept Clin & Expt Med, Neonatol & Neonatal Intens Care Unit, I-56124 Pisa, Italy

[21] Azienda Osped Santa Maria degli Angeli, Pediat & Neonatal Unit, I-33170 Pordenone, Italy

[22] Infermi Hosp, Neonatal Intens Care Unit, I-47923 Rimini, Italy

[23] Santa Maria Nuova Hosp, Neonatal Intens Care Unit, I-42123 Reggio Emilia, Italy

[24] IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Neonatal Intens Care Unit, I-34137 Trieste, Italy

[25] Univ Hosp Udine, Neonatol Unit, I-33100 Udine, Italy

[26] Osped Civile, Unita Operat Pediat & Nido, ASST Pavia, I-27029 Vigevano, Italy

[27] San Martino Hosp, Pediat Unit, I-32100 Belluno, Italy

[28] Ist Super Sanita, Dept Infect Dis, I-00161 Rome, Italy

[29] Univ Modena & Reggio Emilia, Pediat, Dept Med & Surg Sci, I-41124 Modena, Italy

[30] IRCCS Azienda Osped Univ Bologna, Pediat Emergency Unit, I-40138 Bologna, Italy

[31] Guglielmo di Saliceto Hosp, Womens & Childrens Hlth Dept, Pediat & Neonatal Unit, I-29121 Piacenza, Italy

[32] Univ Hosp Parma, Neonatal Intens Care Unit, I-43126 Parma, Italy

来源：

MICROORGANISMS | 2023年 / 11卷 / 06期

关键词：

lumbar puncture; meningitis; sepsis; newborn; prematurity; group B streptococcus; Escherichia coli; BACTERIAL-MENINGITIS; NEONATAL MENINGITIS; CHALLENGES; PATHOGENS; BURDEN;

D O I：

10.3390/microorganisms11061546

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Background: To evaluate the rates of lumbar puncture (LP) in infants with culture-proven sepsis. Study design: We prospectively enrolled 400 infants with early- or late-onset sepsis due to Group B streptococcus (GBS) or Eschericha coli, diagnosed within 90 days of life. Rates of LP and potential variables associated with LP performance were evaluated. Moreover, cerebrospinal fluid (CSF) characteristics and results of the molecular analysis were investigated. Results: LP was performed in 228/400 (57.0%) infants; 123/228 LPs (53.9%) were performed after antibiotic initiation, hampering the ability to identify the pathogen in the CSF culture. However, polymerase chain reaction increased the probability of positive results of CSF analysis compared to microbiological culture (28/79, 35.4% vs. 14/79, 17.7%, p = 0.001). Severe clinical presentation and GBS infection were associated with higher LP rates. The rate of meningitis was 28.5% (65/228). Conclusions: Rates of LP are low in culture-proven neonatal sepsis and antibiotics are frequently given before LP is carried out. Thus meningitis may be underestimated, and the chances of giving an effective therapy to the newborn are reduced. LP should be performed before the start of antibiotics when there is a clinical suspicion of infection.

引用

页数：10

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