title: Neonatal bacterial meningitis.
abstract: Neonatal bacterial meningitis (NM) continues to be a serious disease with an unchanging rate of adverse outcome of 20-60%, despite a worldwide decline in mortality. The 3 major pathogens in developed countries are: Group B streptococcus, gram negative rods and Lysteria monocytogenes. Signs and symptoms of NM may be subtle, unspecific, vague, atypical or absent. In order to exclude NM, all infants with proven or suspected sepsis should undergo lumbar puncture. Positive culture of cerebrospinal fluid may be the only way to diagnose NM and to identify the pathogen, as CSF parameters Smay be normal at early stages and NM may occur frequently (up to 30% of cases) in the absence of bacteraemia. When NM is suspected, treatment must be aggressive, as the goal is to achieve bactericidal concentration of antibiotics and to sterilize CSF as soon as possible. Antibiotics should be administered intravenously, at the highest clinically validated doses. Empiric antibiotic treatment should include agents active against all main pathogens; currently the recommended empiric treatment of NM is ampicillin, plus an aminoglycoside and a third-generation cephalosporn. Therapy should be reassessed after cultures and antibiotic susceptibility is available. Prevention of neonatal sepsis, early recognition of infants at risk, prompt treatment and future adjunctive therapies will improve prognosis. Finally, we present the first preliminary Italian data on GBS meningitis. Data are obtained from an area-based study conducted In Emilia-Romagna during 2003 to 2009.
authors.affiliation: Terapia intensiva neonatale, Azienda Ospedaliera Policlinico, Modena.
authors.forename: A
authors.initials: A
authors.lastname: Berardi
authors.forename: L
authors.initials: L
authors.lastname: Lugli
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: M C
authors.initials: MC
authors.lastname: China
authors.forename: G
authors.initials: G
authors.lastname: Vellani
authors.forename: R
authors.initials: R
authors.lastname: Contiero
authors.forename: F
authors.initials: F
authors.lastname: Calanca
authors.forename: F
authors.initials: F
authors.lastname: Camerlo
authors.forename: F
authors.initials: F
authors.lastname: Casula
authors.forename: C
authors.initials: C
authors.lastname: Di Carlo
authors.forename: M R
authors.initials: MR
authors.lastname: Rossi
authors.forename: R
authors.initials: R
authors.lastname: Chiarabini
authors.forename: M
authors.initials: M
authors.lastname: Ferrari
authors.forename: S
authors.initials: S
authors.lastname: Minniti
authors.forename: C
authors.initials: C
authors.lastname: Venturelli
authors.forename: D
authors.initials: D
authors.lastname: Silvestrini
authors.forename: I
authors.initials: I
authors.lastname: Dodi
authors.forename: A
authors.initials: A
authors.lastname: Zucchini
authors.forename: F
authors.initials: F
authors.lastname: Ferrari
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D011446:Prospective Studies; D013129:Spinal Puncture
chemical_list: D000900:Anti-Bacterial Agents