title: A Meta-analysis of the Rates of Listeria monocytogenes and Enterococcus in Febrile Infants.
abstract: BACKGROUND
  A change in the epidemiology of pathogens causing serious bacterial infection (SBI) has been noted since original recommendations were made for the empirical antibiotic choices for young infants with fever.
  
  
  OBJECTIVE
  To assess the prevalence of SBI caused by Listeria monocytogenes and Enterococcus species.
  
  
  METHODS
  A literature search was conducted on keywords related to SBI, L. monocytogenes, and Enterococcus spp. infections.
  
  
  METHODS
  Eligible studies were those conducted in the United States and published between January 1998 and June 2014 focusing on SBI in infants≤90 days of age.
  
  
  METHODS
  The rates of urinary tract infection, bacteremia, and meningitis for each pathogen were recorded for each study. Meta-analysis was performed to calculate the prevalence for each pathogen in a random effects model with 0.5 continuity correction added to studies with zero events.
  
  
  RESULTS
  Sixteen studies were included. A total of 20,703 blood cultures were included, with weighted prevalences for L. monocytogenes and Enterococcus spp. bacteremia of 0.03% and 0.09%, respectively. A total of 13,775 cerebrospinal fluid cultures were included with event rates (unweighted prevalences) for L. monocytogenes and Enterococcus spp. meningitis of 0.02% and 0.03%, respectively. A total of 18,283 urine cultures were included, with no cases of L. monocytogenes and a weighted prevalence for Enterococcus spp. urinary tract infection of 0.28%.
  
  
  CONCLUSIONS
  There may have been reporting bias or incomplete retrieval or inadvertent exclusion of relevant studies.
  
  
  CONCLUSIONS
  SBI caused by L. monocytogenes and Enterococcus spp. in febrile infants is rare, and therefore clinicians may consider a change in empirical antibiotic choices.
authors.affiliation: Department of Pediatrics, Children's Hospital of the King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia rianna.leazer@chkd.org.
authors.forename: Rianna
authors.initials: R
authors.lastname: Leazer
authors.affiliation: Department of Pediatrics, Children's Hospital of the King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Perkins
authors.affiliation: Department of Pediatrics, Children's Hospital of the King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Kyrie
authors.initials: K
authors.lastname: Shomaker
authors.affiliation: Department of Pediatrics, Children's Hospital of the King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Bryan
authors.initials: B
authors.lastname: Fine
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D016983:Enterococcus / Q000302:isolation & purification; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D008089:Listeria monocytogenes / Q000302:isolation & purification; D008088:Listeriosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008581:Meningitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents