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D Harvey - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Meningitis in England and Wales: sequelae at 5 years of age
European journal of pediatrics, 2005Co-Authors: J De Louvois, S Halket, D HarveyAbstract:This study determined the prevalence of serious sequelae among a national cohort of 5-year old children, born in England and Wales in 1996–7, who had had Neonatal Meningitis. The results were compared with those from two matched control groups. In addition the results from this study were compared with those from a previous 5-year follow-up of children who had had Neonatal Meningitis in 1985–7. Follow-up questionnaires requesting information about the children’s health and development were sent to the general practitioners (GPs) and parents of the index children and controls. Information was collected on 166 of 232 (72%) children who had had Meningitis as neonates, 109 general practice controls and 191 hospital controls. At 5 years, 39/166 (23%) index children had a serious disability compared to 2% of GP controls and 7% of hospital controls. There was a 16-fold increase in risk of serious disability compared to GP-matched controls and a 4-fold increase in risk compared to hospital controls. The isolation of bacteria from the CSF was the best single predictor of serious long-term disability. Although there was a 70% fall in acute phase mortality between 1985 (22%) and 1996 (6.6%), the overall incidence of serious disability remained alarmingly high, 25.5% in 1985 compared to 23.5% in 1996. In the present study, however, fewer children had cerebral palsy or seizure disorders. Conclusion:Despite the dramatic improvement in acute phase survival following Neonatal Meningitis, the prevalence of serious sequelae remains alarmingly high.
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Long term outcome of Neonatal Meningitis
Archives of disease in childhood. Fetal and neonatal edition, 2003Co-Authors: J P Stevens, M Eames, A Kent, S Halket, D E Holt, D HarveyAbstract:Objectives: To quantify long term impairment after Neonatal Meningitis. Design: Longitudinal case-control study over 9–10 years. Subjects and methods: A total of 111 children who had suffered Neonatal Meningitis were seen and compared with 113 matched controls from their birth hospital and 49 controls from general practices. Assessments included the WISC III UK , movement assessment battery for children (mABC), audiometry, vision testing, and social and medical data. Statistical analysis was by multiple regression, analysis of variance, and χ 2 tests. Results: Some 10.8% of cases had a severe and 9% a moderate overall outcome compared with 0% and 1.8% for the hospital controls. The mean intelligence quotient (IQ) of the cases (88.8) was significantly less than that of the hospital controls (99.4) or the GP controls (99.6) . The mABC score was significantly worse for the cases (7.08) than the hospital (5) or GP (4) controls. Some 3.6% of cases had sensorineural hearing loss, 2.7% had persisting hydrocephalus; no controls did. Some 5.4% of cases and 1.7% of hospital controls had treatment for seizures. Conclusions: Severe neurodisability and milder motor and psychometric impairment result from Neonatal Meningitis. Both clinical follow up and comprehensive developmental assessment are needed after this disease.
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Neonatal Meningitis in England and Wales: 10 years on
Archives of disease in childhood. Fetal and neonatal edition, 2001Co-Authors: D E Holt, S Halket, J De Louvois, D HarveyAbstract:OBJECTIVES To determine the incidence of Neonatal Meningitis in England and Wales. DESIGN A national postal survey using the British Paediatric Surveillance Unit (BPSU) card scheme supplemented by information from other sources. SETTING England and Wales 1996–1997. SUBJECTS A total of 274 babies less than 28 days of age who were treated for Meningitis. RESULTS The incidence of Neonatal Meningitis in England and Wales has not changed since our previous study in 1985–1987. However, the acute phase mortality has fallen from 19.8% in 1985–1987 to 6.6% in this study. Group B streptococci (42%) and Escherichia coli (16%) remain the most common infecting microorganisms. Eight of 69 (12%) babies with group B streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on the third generation cephalosporins, notably cefotaxime, were most commonly used (84%). The BPSU scheme identified 72% of cases during the study period. Most cases of viral Meningitis were not reported through the BPSU. Less than a third of samples from aseptic Meningitis were examined for viruses; 56% of these were positive. CONCLUSIONS Although the incidence of Neonatal Meningitis remains unchanged, mortality from this infection has fallen significantly. If this improvement is maintained as reflected in the level of sequelae at 5 years of age, then the fear surrounding Meningitis during the Neonatal period will have been dramatically reduced.
Edouard Bingen - One of the best experts on this subject based on the ideXlab platform.
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Antimicrobial susceptibility of 136 Escherichia coli isolates from cases of Neonatal Meningitis and relationship with virulence.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2007Co-Authors: Véronique Houdouin, Stéphane Bonacorsi, Philippe Bidet, Edouard BingenAbstract:The susceptibility of 136 Escherichia coli isolates from cases of Neonatal Meningitis to amoxycillin, ceftriaxone, nalidixic acid, ciprofloxacin and gentamicin was determined in relation to the carriage of virulence factors and phylogenetic group. Only amoxycillin and nalidixic acid resistance was observed (40% and 3%, respectively). Nalidixic acid resistance alone was associated with non-virulent phylogenetic group A (50% vs. 6% of susceptible isolates; p 0.03). No difference in virulence was observed between two representative nalidixic acid-susceptible virulent group B2 isolates and their nalidixic acid-resistant derivatives in a rat model of Neonatal Meningitis, suggesting that nalidixic acid resistance does not affect the virulence of E. coli strains causing Meningitis.
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Two cases of Pseudomonas aeruginosa Neonatal Meningitis treated by ciprofloxacine
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 2006Co-Authors: D. Tanase-derkaoui, Edouard Bingen, P. Le Huidoux, C. Farnoux, F. El-moussawi, P. Mariani-kurkdjian, Olivier Baud, Y. AujardAbstract:Two cases of Pseudomonas aeruginosa Neonatal Meningitis are reported. Case 1 occurred on day 6 of life, at home, in a full term newborn. Favourable outcome was obtained with a treatment associating ceftazidime, 21 days, gentamicin, 10 days and ciprofloxacin, 10 days. Case no 2 was a nosocomial Meningitis in a 32 weeks and 4 days gestational age premature newborn. Despite in vitro effective antibiotherapy with ceftazidime, netilmicine and ciprofloxacine, six cerebral abscesses were observed during the second week of treatment. Ceftazidime was stopped after 6 weeks and ciprofloxacine prolonged until neuroradiological cure of cerebral lesions at one year of age. Normal outcome was observed at 3 and 4 and half year of age. Therapeutic indications and clinical tolerance of ciprofloxacine in Neonatal Meningitis are discussed.
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Molecular epidemiology of Escherichia coli causing Neonatal Meningitis.
International journal of medical microbiology : IJMM, 2005Co-Authors: Stéphane Bonacorsi, Edouard BingenAbstract:Escherichia coli is the second cause of Neonatal Meningitis which is a major cause of Neonatal mortality and is associated with a high incidence of neurological sequelae. E. coli Neonatal Meningitis (ECNM) strains, as other extraintestinal pathogenic E. coli, mainly belong to the phylogenetic group B2 and to a lesser extent to group D, but are distributed in fewer clonal groups. One of these, the O18:K1:H7 clone is worldwide distributed meanwhile others such as O83:K1 and O45:K1 are restricted to some countries. Over the past few years, major progress has been made in the understanding of the pathophysiology of E. coli O18:K1:H7 Neonatal Meningitis. In particular, specific virulence factors have been identified and are known to be carried by ectochromosomal DNA in most cases. Molecular epidemiological studies, including characterization of virulence genotypes and phylogenetic analysis are important to lead to a comprehensive picture of the origins and spread of virulence factors within the population of ECNM strains. To date, all the known genetic determinants obtained in ECNM strains are not sufficient to explain their virulence in their globality and further studies on clonal groups different from the archetypal O18:K1:H7 clone are needed. These studies would serve to find common pathogenic mechanisms among different ECNM clonal groups that may be used as potential target for a worldwide efficacious prevention strategy.
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Characterization of an Anonymous Molecular Marker Strongly Linked to Escherichia coli Strains Causing Neonatal Meningitis
Journal of clinical microbiology, 2004Co-Authors: Olivier Clermont, Stéphane Bonacorsi, Edouard BingenAbstract:An anonymous 14.9-kb rrn-containing HindIII fragment is strongly linked to Escherichia coli strains causing Neonatal Meningitis. We show in this report that this fragment does not encode new virulence factors but lacks arpA, a gene common in avirulent E. coli strains, and we developed a PCR test to detect this fragment.
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A Uropathogenicity Island Contributes to the Pathogenicity of Escherichia coli Strains That Cause Neonatal Meningitis
Infection and immunity, 2002Co-Authors: Véronique Houdouin, Stéphane Bonacorsi, Naima Brahimi, Olivier Clermont, Xavier Nassif, Edouard BingenAbstract:We report that the archetypal Escherichia coli strain C5 causing Neonatal Meningitis harbors a pathogenicity island (PAI) designated PAI I(C5) that is similar to the PAI II(J96) of uropathogenic E. coli J96 inserted in the leuX-tRNA gene. PAI-negative C5 mutants had a lower capacity than C5 to induce high-level bacteremia in a Neonatal rat model. However, no change in their resistance to the bactericidal effect of serum and their capacity to cross the blood-brain barrier was observed.
S Halket - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Meningitis in England and Wales: sequelae at 5 years of age
European journal of pediatrics, 2005Co-Authors: J De Louvois, S Halket, D HarveyAbstract:This study determined the prevalence of serious sequelae among a national cohort of 5-year old children, born in England and Wales in 1996–7, who had had Neonatal Meningitis. The results were compared with those from two matched control groups. In addition the results from this study were compared with those from a previous 5-year follow-up of children who had had Neonatal Meningitis in 1985–7. Follow-up questionnaires requesting information about the children’s health and development were sent to the general practitioners (GPs) and parents of the index children and controls. Information was collected on 166 of 232 (72%) children who had had Meningitis as neonates, 109 general practice controls and 191 hospital controls. At 5 years, 39/166 (23%) index children had a serious disability compared to 2% of GP controls and 7% of hospital controls. There was a 16-fold increase in risk of serious disability compared to GP-matched controls and a 4-fold increase in risk compared to hospital controls. The isolation of bacteria from the CSF was the best single predictor of serious long-term disability. Although there was a 70% fall in acute phase mortality between 1985 (22%) and 1996 (6.6%), the overall incidence of serious disability remained alarmingly high, 25.5% in 1985 compared to 23.5% in 1996. In the present study, however, fewer children had cerebral palsy or seizure disorders. Conclusion:Despite the dramatic improvement in acute phase survival following Neonatal Meningitis, the prevalence of serious sequelae remains alarmingly high.
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Long term outcome of Neonatal Meningitis
Archives of disease in childhood. Fetal and neonatal edition, 2003Co-Authors: J P Stevens, M Eames, A Kent, S Halket, D E Holt, D HarveyAbstract:Objectives: To quantify long term impairment after Neonatal Meningitis. Design: Longitudinal case-control study over 9–10 years. Subjects and methods: A total of 111 children who had suffered Neonatal Meningitis were seen and compared with 113 matched controls from their birth hospital and 49 controls from general practices. Assessments included the WISC III UK , movement assessment battery for children (mABC), audiometry, vision testing, and social and medical data. Statistical analysis was by multiple regression, analysis of variance, and χ 2 tests. Results: Some 10.8% of cases had a severe and 9% a moderate overall outcome compared with 0% and 1.8% for the hospital controls. The mean intelligence quotient (IQ) of the cases (88.8) was significantly less than that of the hospital controls (99.4) or the GP controls (99.6) . The mABC score was significantly worse for the cases (7.08) than the hospital (5) or GP (4) controls. Some 3.6% of cases had sensorineural hearing loss, 2.7% had persisting hydrocephalus; no controls did. Some 5.4% of cases and 1.7% of hospital controls had treatment for seizures. Conclusions: Severe neurodisability and milder motor and psychometric impairment result from Neonatal Meningitis. Both clinical follow up and comprehensive developmental assessment are needed after this disease.
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Neonatal Meningitis in England and Wales: 10 years on
Archives of disease in childhood. Fetal and neonatal edition, 2001Co-Authors: D E Holt, S Halket, J De Louvois, D HarveyAbstract:OBJECTIVES To determine the incidence of Neonatal Meningitis in England and Wales. DESIGN A national postal survey using the British Paediatric Surveillance Unit (BPSU) card scheme supplemented by information from other sources. SETTING England and Wales 1996–1997. SUBJECTS A total of 274 babies less than 28 days of age who were treated for Meningitis. RESULTS The incidence of Neonatal Meningitis in England and Wales has not changed since our previous study in 1985–1987. However, the acute phase mortality has fallen from 19.8% in 1985–1987 to 6.6% in this study. Group B streptococci (42%) and Escherichia coli (16%) remain the most common infecting microorganisms. Eight of 69 (12%) babies with group B streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on the third generation cephalosporins, notably cefotaxime, were most commonly used (84%). The BPSU scheme identified 72% of cases during the study period. Most cases of viral Meningitis were not reported through the BPSU. Less than a third of samples from aseptic Meningitis were examined for viruses; 56% of these were positive. CONCLUSIONS Although the incidence of Neonatal Meningitis remains unchanged, mortality from this infection has fallen significantly. If this improvement is maintained as reflected in the level of sequelae at 5 years of age, then the fear surrounding Meningitis during the Neonatal period will have been dramatically reduced.
D E Holt - One of the best experts on this subject based on the ideXlab platform.
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Long term outcome of Neonatal Meningitis
Archives of disease in childhood. Fetal and neonatal edition, 2003Co-Authors: J P Stevens, M Eames, A Kent, S Halket, D E Holt, D HarveyAbstract:Objectives: To quantify long term impairment after Neonatal Meningitis. Design: Longitudinal case-control study over 9–10 years. Subjects and methods: A total of 111 children who had suffered Neonatal Meningitis were seen and compared with 113 matched controls from their birth hospital and 49 controls from general practices. Assessments included the WISC III UK , movement assessment battery for children (mABC), audiometry, vision testing, and social and medical data. Statistical analysis was by multiple regression, analysis of variance, and χ 2 tests. Results: Some 10.8% of cases had a severe and 9% a moderate overall outcome compared with 0% and 1.8% for the hospital controls. The mean intelligence quotient (IQ) of the cases (88.8) was significantly less than that of the hospital controls (99.4) or the GP controls (99.6) . The mABC score was significantly worse for the cases (7.08) than the hospital (5) or GP (4) controls. Some 3.6% of cases had sensorineural hearing loss, 2.7% had persisting hydrocephalus; no controls did. Some 5.4% of cases and 1.7% of hospital controls had treatment for seizures. Conclusions: Severe neurodisability and milder motor and psychometric impairment result from Neonatal Meningitis. Both clinical follow up and comprehensive developmental assessment are needed after this disease.
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Neonatal Meningitis in England and Wales: 10 years on
Archives of disease in childhood. Fetal and neonatal edition, 2001Co-Authors: D E Holt, S Halket, J De Louvois, D HarveyAbstract:OBJECTIVES To determine the incidence of Neonatal Meningitis in England and Wales. DESIGN A national postal survey using the British Paediatric Surveillance Unit (BPSU) card scheme supplemented by information from other sources. SETTING England and Wales 1996–1997. SUBJECTS A total of 274 babies less than 28 days of age who were treated for Meningitis. RESULTS The incidence of Neonatal Meningitis in England and Wales has not changed since our previous study in 1985–1987. However, the acute phase mortality has fallen from 19.8% in 1985–1987 to 6.6% in this study. Group B streptococci (42%) and Escherichia coli (16%) remain the most common infecting microorganisms. Eight of 69 (12%) babies with group B streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on the third generation cephalosporins, notably cefotaxime, were most commonly used (84%). The BPSU scheme identified 72% of cases during the study period. Most cases of viral Meningitis were not reported through the BPSU. Less than a third of samples from aseptic Meningitis were examined for viruses; 56% of these were positive. CONCLUSIONS Although the incidence of Neonatal Meningitis remains unchanged, mortality from this infection has fallen significantly. If this improvement is maintained as reflected in the level of sequelae at 5 years of age, then the fear surrounding Meningitis during the Neonatal period will have been dramatically reduced.
J De Louvois - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Meningitis in England and Wales: sequelae at 5 years of age
European journal of pediatrics, 2005Co-Authors: J De Louvois, S Halket, D HarveyAbstract:This study determined the prevalence of serious sequelae among a national cohort of 5-year old children, born in England and Wales in 1996–7, who had had Neonatal Meningitis. The results were compared with those from two matched control groups. In addition the results from this study were compared with those from a previous 5-year follow-up of children who had had Neonatal Meningitis in 1985–7. Follow-up questionnaires requesting information about the children’s health and development were sent to the general practitioners (GPs) and parents of the index children and controls. Information was collected on 166 of 232 (72%) children who had had Meningitis as neonates, 109 general practice controls and 191 hospital controls. At 5 years, 39/166 (23%) index children had a serious disability compared to 2% of GP controls and 7% of hospital controls. There was a 16-fold increase in risk of serious disability compared to GP-matched controls and a 4-fold increase in risk compared to hospital controls. The isolation of bacteria from the CSF was the best single predictor of serious long-term disability. Although there was a 70% fall in acute phase mortality between 1985 (22%) and 1996 (6.6%), the overall incidence of serious disability remained alarmingly high, 25.5% in 1985 compared to 23.5% in 1996. In the present study, however, fewer children had cerebral palsy or seizure disorders. Conclusion:Despite the dramatic improvement in acute phase survival following Neonatal Meningitis, the prevalence of serious sequelae remains alarmingly high.
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Neonatal Meningitis in England and Wales: 10 years on
Archives of disease in childhood. Fetal and neonatal edition, 2001Co-Authors: D E Holt, S Halket, J De Louvois, D HarveyAbstract:OBJECTIVES To determine the incidence of Neonatal Meningitis in England and Wales. DESIGN A national postal survey using the British Paediatric Surveillance Unit (BPSU) card scheme supplemented by information from other sources. SETTING England and Wales 1996–1997. SUBJECTS A total of 274 babies less than 28 days of age who were treated for Meningitis. RESULTS The incidence of Neonatal Meningitis in England and Wales has not changed since our previous study in 1985–1987. However, the acute phase mortality has fallen from 19.8% in 1985–1987 to 6.6% in this study. Group B streptococci (42%) and Escherichia coli (16%) remain the most common infecting microorganisms. Eight of 69 (12%) babies with group B streptococci and 4/26 (15%) with E coli died. Antibiotic regimens based on the third generation cephalosporins, notably cefotaxime, were most commonly used (84%). The BPSU scheme identified 72% of cases during the study period. Most cases of viral Meningitis were not reported through the BPSU. Less than a third of samples from aseptic Meningitis were examined for viruses; 56% of these were positive. CONCLUSIONS Although the incidence of Neonatal Meningitis remains unchanged, mortality from this infection has fallen significantly. If this improvement is maintained as reflected in the level of sequelae at 5 years of age, then the fear surrounding Meningitis during the Neonatal period will have been dramatically reduced.
