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

Journal of Perinatology (2024)Cite this article

Subjects

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.

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Data availability

The data that support the findings of the study are available upon reasonable request.

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Funding

Funding

This work was funded by the Duke Clinical Research Institute’s R25 Summer Training in Academic Research (STAR) Program (grant #5R25HD076475-10). This work was also funded in part by (U24TR001608) of the NCATS Trial Innovation Network. This work was also funded under the National Institute of Child Health and Human Development (NICHD) contract (HHSN275201000003I) for the Pediatric Trials Network (PI Danny Benjamin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Duke University, Durham, NC, USA

    Samia Aleem, Daniel K. Benjamin Jr, Kanecia O. Zimmerman & Rachel G. Greenberg

  2. Duke Clinical Research Institute, Durham, NC, USA

    Daniel K. Benjamin Jr, Jacob Duncan, Kalkidan Melaku, Abdulaziz Norbekov, Bethany Graham, Sriya Mantena, Tomi Ladipo, Kanecia O. Zimmerman & Rachel G. Greenberg

  3. Department of Medicine, Duke University, Durham, NC, USA

    Charles M. Burns

  4. Cary Academy, Cary, NC, USA

    Ayan Jung

  5. Pediatrix Center for Research, Education, Quality, and Safety, Sunrise, FL, USA

    Reese H. Clark

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  1. Samia Aleem
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Contributions

RGG had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: SA, RGG, Acquisition, analysis, or interpretation of data: SA, DKB, RGG, Statistical analysis: RGG, SA, Drafting of the manuscript: SA, DKB, RGG, Critical revision of the manuscript for important intellectual content: All authors. Review and approval of the manuscript for submission: All authors.

Corresponding authors

Correspondence to Daniel K. Benjamin Jr or Rachel G. Greenberg.

Ethics declarations

Competing interests

DKB reports consultancy for Allergan, Melinta Therapeutics, and Sun Pharma Advanced Research Co. KOZ reports funding from the National Institutes of Health (NIH) and US Food and Drug Administration (FDA). RGG reports support from industry for research services (https://dcri.org/about-us/conflict-of-interest/). All other authors report no conflicts of interest.

Ethics approval

This study was approved by the Duke University Institutional Review Board as exempt research. This study was performed in accordance with the Declaration of Helsinki.

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Aleem, S., Benjamin, D.K., Burns, C.M. et al. Epidemiology and outcomes of bacterial meningitis in the neonatal intensive care unit. J Perinatol (2024). https://doi.org/10.1038/s41372-024-02069-0

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