First name
Pediatric
Middle name
Emergency Medicine Collaborative Research Committee HSV Study
Last name
Group*
Nickname
PEM CRC

Title

Test Characteristics of Cerebrospinal Fluid Gram Stain to Identify Bacterial Meningitis in Infants Younger Than 60 Days.

Year of Publication

2018

Number of Pages

Date Published

2018 Nov 12

ISSN Number

1535-1815

Abstract

<p>In our cohort of 20,947 infants aged 60 days or younger, cerebrospinal fluid Gram stain had a sensitivity of 34.3% (95% confidence interval, 28.1%-41.1%) and a positive predictive value of 61.4% (95% confidence interval, 52.2%-69.8%) for positive cerebrospinal fluid culture, suggesting that Gram stain alone may lead to both underdiagnosis and overdiagnosis of bacterial meningitis.</p>

DOI

10.1097/PEC.0000000000001639

Alternate Title

Pediatr Emerg Care

PMID

30422943
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Title

Cerebrospinal Fluid Reference Values for Young Infants Undergoing Lumbar Puncture.

Year of Publication

2018

Number of Pages

Date Published

2018 Feb 02

ISSN Number

1098-4275

Abstract

<p><strong>OBJECTIVES: </strong>To determine age-specific reference values and quantify age-related changes for cerebrospinal fluid (CSF) white blood cell (WBC) counts and protein and glucose concentrations in infants ≤60 days of age.</p>

<p><strong>METHODS: </strong>This multicenter, cross-sectional study included infants ≤60 days old with CSF cultures and complete CSF profiles obtained within 24 hours of presentation. Those with conditions suspected or known to cause abnormal CSF parameters (eg, meningitis) and those with a hospital length of stay of &gt;72 hours were excluded. Reference standards were determined for infants ≤28 days of age and 29 to 60 days of age by using the third quartile +1.5 interquartile range for WBC and protein and the first quartile -1.5 interquartile range for glucose. CSF parameter centile curves based on age were calculated by using the LMST method.</p>

<p><strong>RESULTS: </strong>A total of 7766 patients were included. CSF WBC counts were higher in infants ≤28 days of age (upper bound: 15 cells/mm) than in infants 29 to 60 days of age (upper bound: 9 cells/mm;&lt; .001). CSF protein concentrations were higher in infants ≤28 days of age (upper bound: 127 mg/dL) than in infants 29 to 60 days of age (upper bound: 99 mg/dL;&lt; .001). CSF glucose concentrations were lower in infants ≤28 days of age (lower bound: 25 mg/dL) than in infants 29 to 60 days of age (lower bound: 27 mg/dL;&lt; .001).</p>

<p><strong>CONCLUSIONS: </strong>The age-specific CSF WBC count, protein concentration, and glucose concentration reference values identified in this large, multicenter cohort of infants can be used to interpret the results of lumbar puncture in infants ≤60 days of age.</p>

DOI

10.1542/peds.2017-3405

Alternate Title

Pediatrics

PMID

29437883
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Title

Concomitant Bacterial Meningitis in Infants With Urinary Tract Infection.

Year of Publication

2017

Number of Pages

908-910

Date Published

2017 09

ISSN Number

1532-0987

Abstract

<p>To determine age-stratified prevalence of concomitant bacterial meningitis in infants ≤60 days with a urinary tract infection, we performed a 23-center, retrospective study of 1737 infants with urinary tract infection. Concomitant bacterial meningitis was rare, but more common in infants 0-28 days of age [0.9%; 95% confidence interval (CI): 0.4%-1.9%) compared with infants 29-60 days of age (0.2%; 95% CI: 0%-0.8%).</p>

DOI

10.1097/INF.0000000000001626

Alternate Title

Pediatr. Infect. Dis. J.

PMID

28472006
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