title: Neonatal Bacterial Meningitis: 444 Cases in 7 Years.
abstract: BACKGROUND
  Neonatal bacterial meningitis remains a severe infectious disease with mortality rates varying between 10% and 15%. The clinical and bacteriologic features of neonatal meningitis collected from January 2001 to December 2007 in a French national survey are presented here.
  
  
  METHODS
  Cases of neonatal meningitis were prospectively collected by a network of 252 pediatric wards covering 61% of French pediatric wards, associated with 168 microbiology laboratories. Neonatal meningitis was classified as early-onset (d0-d4) and late-onset (d5-d28). Statistical analyses were performed according to gestational age and weight at birth.
  
  
  RESULTS
  A total of 444 cases of neonatal bacterial meningitis were reported by 114 pediatric wards. Five cases were excluded from analysis. Group B streptococci (GBS) and Escherichia coli accounted respectively for 59% and 28% of the cases, followed by Gram-negative bacilli other than E. coli (4%), other streptococci (4%), Neisseria meningitidis (3%), and Listeria monocytogenes (1.5%). GBS was the most common pathogen both in early-onset (77% vs. 18% for E. coli) and in late-onset meningitis (50% vs. 33% for E. coli). Among preterm infants, E. coli was more commonly isolated (45% vs. 32% for GBS), especially in very preterm infants (54%). GBS was more often involved in seizures than E. coli (41% vs. 25%). The overall mortality rate was 13% but reached 25% in preterm or small for gestational age infants, regardless of the etiology.
  
  
  CONCLUSIONS
  GBS was the dominant cause of neonatal bacterial meningitis, with 77% of early-onset and 50% of late-onset cases. E. coli was the most common bacteria in preterm infants.
authors.affiliation: Service de Pédiatrie et Réanimation Néonatales, Hôpital Antoine-Béclère, Université Paris-Sud, Clamart, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gaschignard
authors.forename: Corinne
authors.initials: C
authors.lastname: Levy
authors.forename: Olivier
authors.initials: O
authors.lastname: Romain
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.forename: Edouard
authors.initials: E
authors.lastname: Bingen
authors.forename: Yannick
authors.initials: Y
authors.lastname: Aujard
authors.forename: Pascal
authors.initials: P
authors.lastname: Boileau
mesh_terms: D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D020814:Meningitis, Escherichia coli; D008584:Meningitis, Listeria; D015995:Prevalence; D011446:Prospective Studies