Romain Basmaci1, Stéphane Bonacorsi2, Philippe Bidet2, Valérie Biran3, Yannick Aujard3, Edouard Bingen4, Stéphane Béchet5, Robert Cohen6, Corinne Levy7. 1. Infection, Antimicrobials, Modelling, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé Et de la Recherche Médicale IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité Assistance Publique - Hôpitaux de Paris (AP-HP), Laboratoire de Microbiologie, Centre National de Référence associé Escherichia coli AP-HP, Service de Pédiatrie Générale. 2. Infection, Antimicrobials, Modelling, Evolution (IAME), Unité Mixte de Recherche (UMR) 1137, Institut National de la Santé Et de la Recherche Médicale IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité Assistance Publique - Hôpitaux de Paris (AP-HP), Laboratoire de Microbiologie, Centre National de Référence associé Escherichia coli. 3. AP-HP, Service de Réanimation et Pédiatrie Néonatales, Hôpital Robert-Debré, Paris. 4. Assistance Publique - Hôpitaux de Paris (AP-HP), Laboratoire de Microbiologie, Centre National de Référence associé Escherichia coli. 5. Association Clinique Thérapeutique Infantile du Val de Marne, Saint Maur des Fossés. 6. Association Clinique Thérapeutique Infantile du Val de Marne, Saint Maur des Fossés Groupe de Pathologie Infectieuse Pédiatrique, Paris Unité Court Séjour, Petits Nourrisson, Service de Néonatologie Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France. 7. Association Clinique Thérapeutique Infantile du Val de Marne, Saint Maur des Fossés Groupe de Pathologie Infectieuse Pédiatrique, Paris Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France.
Abstract
BACKGROUND: We aimed to describe features of Escherichia coli meningitis in a large population of children and the molecular characteristics of the involved strains to determine factors associated with severe disease or death. METHODS: Between 2001 and 2013, a prospective national survey collected data for 325 children hospitalized with E. coli meningitis. The national reference center genetically characterized 141 isolates. RESULTS: Among the 325 cases, 65.2% were term, 22.4% late preterm, and 12.5% very/extremely preterm infants. Escherichia coli meningitis was 7-fold more frequent in preterm than term infants. Median age at diagnosis was 14 days; 71.1% of infants were neonates, with 2 peaks of infection at age 0-3 days (mostly preterm neonates) and 11-15 days (mostly term neonates); 8.9% were >89 days old. In total, 51.1% patients were considered to have severe disease, and 9.2% died. B2.1 phylogenetic subgroup (56%) and O1 serogroup (27.7%) were the most frequently identified. On multivariate analysis, death was associated with preterm birth (odds ratio [OR], 3.3 [95% confidence interval {CI}, 1.3-8.4], P = .015 for late preterm infants; OR, 7.3 [95% CI, 2.7-20.9], P < .001 for very/extremely preterm infants) and cerebrospinal fluid (CSF) to blood glucose ratio <0.10 (OR, 15.3 [95% CI, 1.8-128.3], P = .012). Death was associated with uncommon O serogroup strains (P = .014) and severe disease with O7 serogroup (P = .034) and PapGII adhesin (OR, 2.3 [95% CI, 1.2-4.5], P = .015). CONCLUSIONS: In this large study of 325 cases of E. coli meningitis, risk factors of severe disease or death were preterm birth, severe hypoglycorrhachia, CSF/blood glucose ratio <0.10, and molecular characteristics of strains, which should help optimize therapeutic management.
BACKGROUND: We aimed to describe features of Escherichia coli meningitis in a large population of children and the molecular characteristics of the involved strains to determine factors associated with severe disease or death. METHODS: Between 2001 and 2013, a prospective national survey collected data for 325 children hospitalized with E. coli meningitis. The national reference center genetically characterized 141 isolates. RESULTS: Among the 325 cases, 65.2% were term, 22.4% late preterm, and 12.5% very/extremely preterm infants. Escherichia coli meningitis was 7-fold more frequent in preterm than term infants. Median age at diagnosis was 14 days; 71.1% of infants were neonates, with 2 peaks of infection at age 0-3 days (mostly preterm neonates) and 11-15 days (mostly term neonates); 8.9% were >89 days old. In total, 51.1% patients were considered to have severe disease, and 9.2% died. B2.1 phylogenetic subgroup (56%) and O1 serogroup (27.7%) were the most frequently identified. On multivariate analysis, death was associated with preterm birth (odds ratio [OR], 3.3 [95% confidence interval {CI}, 1.3-8.4], P = .015 for late preterm infants; OR, 7.3 [95% CI, 2.7-20.9], P < .001 for very/extremely preterm infants) and cerebrospinal fluid (CSF) to blood glucose ratio <0.10 (OR, 15.3 [95% CI, 1.8-128.3], P = .012). Death was associated with uncommon O serogroup strains (P = .014) and severe disease with O7 serogroup (P = .034) and PapGII adhesin (OR, 2.3 [95% CI, 1.2-4.5], P = .015). CONCLUSIONS: In this large study of 325 cases of E. coli meningitis, risk factors of severe disease or death were preterm birth, severe hypoglycorrhachia, CSF/blood glucose ratio <0.10, and molecular characteristics of strains, which should help optimize therapeutic management.
Authors: David M Gordon; Sarah Geyik; Olivier Clermont; Claire L O'Brien; Shiwei Huang; Charmalie Abayasekara; Ashwin Rajesh; Karina Kennedy; Peter Collignon; Paul Pavli; Christophe Rodriguez; Brian D Johnston; James R Johnson; Jean-Winoc Decousser; Erick Denamur Journal: mSphere Date: 2017-05-31 Impact factor: 4.389
Authors: Dirkje de Blauw; Ahl Bruning; L J Vijn; J G Wildenbeest; K C Wolthers; M H Biezeveld; Anne-Marie van Wermeskerken; Femke Nauta; Dasja Pajkrt Journal: Medicine (Baltimore) Date: 2019-06 Impact factor: 1.817
Authors: Yanli Liu; Minli Zhu; Xiaoqin Fu; Jiaojiao Cai; Shangqin Chen; Yuanyuan Lin; Na Jiang; Si Chen; Zhenlang Lin Journal: Int J Gen Med Date: 2021-06-29