title: Repeat lumbar punctures in infants with meningitis in the neonatal intensive care unit.
abstract: OBJECTIVE
  The purpose of this study is to examine the results of repeat lumbar puncture in infants with initial positive cerebrospinal fluid (CSF) cultures in order to determine the clinical characteristics and outcomes of infants with repeat positive cultures.
  
  
  METHODS
  Cohort study of infants with an initial positive CSF culture undergoing repeat lumbar puncture between 1997 and 2004 at 150 neonatal intensive care units managed by the Pediatrix Medical group. We compared the clinical outcomes of infants with repeat positive cultures and infants with repeat negative cultures.
  
  
  RESULTS
  We identified 118 infants with repeat CSF cultures. Of these, 26 infants had repeat positive cultures. A higher proportion with repeat positive cultures died compared with those with repeat negative cultures, 6/23 (26%) vs. 6/81 (7%), respectively (P=0.02).
  
  
  CONCLUSIONS
  Among infants with a positive CSF culture, a repeat positive CSF culture is common. The presence of a second positive culture is associated with increased mortality.
authors.affiliation: Department of Pediatrics, Duke University, Durham, NC, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Greenberg
authors.forename: D K
authors.initials: DK
authors.lastname: Benjamin
authors.forename: M
authors.initials: M
authors.lastname: Cohen-Wolkowiez
authors.forename: R H
authors.initials: RH
authors.lastname: Clark
authors.forename: C M
authors.initials: CM
authors.lastname: Cotten
authors.forename: M
authors.initials: M
authors.lastname: Laughon
authors.forename: P B
authors.initials: PB
authors.lastname: Smith
mesh_terms: D001431:Bacteriological Techniques; D002177:Candidiasis / Q000382:microbiology* / Q000401:mortality; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D053208:Kaplan-Meier Estimate; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology* / Q000401:mortality; D016921:Meningitis, Fungal / Q000382:microbiology* / Q000401:mortality; D011379:Prognosis; D013129:Spinal Puncture