I. Kopsidas, C. Kortsalioudaki, E. Kourkouni, N. Spyridis, T. Zaoutis, P. Heath  

36th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID 2018)
Malmö, Sweeden, May 28- June 2, 2018

BACKGROUND: Bacterial meningitis is a serious condition in neonates, associated with high mortality and long-term significant sequelae which has not improved in decades, despite the advent of improved antimicrobial-therapy. Clinical presentation of neonatal meningitis is non-specific and affected babies cannot be easily distinguished from those with other septic foci or even unwell babies without infections. Timely and appropriate antibiotic-therapy may promote more favorable outcomes. The study aims to describe the neonates treated for meningitis in an infection-surveillance network and the pathogens involved.

METHODS:  neonIN is an international web-based surveillance database for culture-proven neonatal infections. Cases of neonates treated for meningitis were extracted and analysed. Repeated growth of the same organism was considered the same episode if occurring within 7 days, or 10 days for Coagulase-negative staphylococci (CONS) and fungi.

RESULTS:  492/6227 episodes of sepsis were treated for meningitis. Median birth-weight and gestational-age was of 1180gr(IQR:770-2570) and 29 weeks(IQR:25-36)respectively. Pathogen was identified in CSF in 22.2% of the cases and in blood in 87%. Overall CoNS(115,23.3%) appeared to be the most common isolate in cases that clinicians treated as meningitis. When CoNS was excluded E.coli (81,16.4%) was the most common pathogen followed by GBS (77,15.6%) and Klebsiella sp (41,8.3%). Table-1 shows stratification for UK and Greece. Infants treated in the UK were of lower birth-weight, earlier gestational-age and had the majority of GBS cases.

CONCLUSIONS: Meningitis is a life-threatening disease, with a higher incidence in preterm-infants. A positive-culture from CSF is the traditional standard for diagnosis but in this study appears to be less frequent, reflecting the challenges associated with the diagnosis of meningitis in this population. The potential for under-ascertainment along with the interpretation of CoNS as a cause of meningitis, require further exploration.