title: Childhood meningitis caused by Streptococcus bovis group: clinical and biologic data during a 12-year period in France.
abstract: BACKGROUND
  Bacterial meningitis (BM) is a major cause of morbidity and mortality in children. Sporadic cases of Streptococcus bovis have been described in neonates and infants. To assess the epidemiologic, clinical and biologic characteristics of this meningitis, we used the French Surveillance Network for BM in children.
  
  
  METHODS
  Two hundred and twenty-seven pediatric wards working with 168 microbiology departments throughout France were asked to report all cases of BM in patients <18 years. Diagnosis was based on a combination of fever, meningeal signs and a positive cerebrospinal fluid (CSF) culture and/or a positive polymerase chain reaction in the CSF and/or positive blood culture associated with pleiocytosis.
  
  
  RESULTS
  Among 4806 cases of BM recorded in 12 years (2001-2012), 23 cases were caused by S. bovis (0.5%). All were infants. Among them, 15 cases (65.2%) occurred in the neonatal period. The majority occurred in premature infants (73.9%). In 21 cases, the diagnosis was based on a positive CSF culture. Blood culture was positive in 17 children. When S. bovis subtype was identified, it was type 2 (Streptococcus gallolyticus pasteurianus) in 80% of cases. All infants received antibiotic therapy with parenteral penicillin and/or third-generation cephalosporin combined with an aminoglycoside. The duration of treatment ranged from 10 to 25 days. Of the 23 patients, 17 (73.9%) had a second lumbar puncture and in all those cases, the CSF was sterile. No deaths or neurologic complications were reported.
  
  
  CONCLUSIONS
  BM due to S. bovis is rare and primarily affects infants, particularly premature infants. Antibiotic treatment is effective with low morbidity and mortality.
authors.affiliation: From the *Department of Pediatrics, Centre Hospitalier de Versailles, Le Chesnay; †ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint Maur les Fossés; ‡GPIP, Pediatric Infectious Disease Group; §Clinical Research Center (CRC); ¶Department of Pediatrics, Centre Hospitalier Intercommunal de Créteil, Créteil; and ‖Department of Microbiology, Hôpital Cochin, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Beneteau
authors.forename: Corinne
authors.initials: C
authors.lastname: Levy
authors.forename: Pierre
authors.initials: P
authors.lastname: Foucaud
authors.forename: Stéphane
authors.initials: S
authors.lastname: Béchet
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.forename: Josette
authors.initials: J
authors.lastname: Raymond
authors.forename: Marie-Aliette
authors.initials: MA
authors.lastname: Dommergues
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007964:Leukocytosis / Q000097:blood; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D016985:Streptococcus bovis / Q000302:isolation & purification*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents