Risk of Meningitis in Infants Aged 29 to 90 Days with Urinary Tract Infection: A Systematic Review and Meta-Analysis - 19/08/19
, Molly Childers, MD 3, Nicholas Singh-Miller, MD, PhD 4, Robin Howard, MA 5, Rhonda Allard, MLIS 6, Matthew Eberly, MD 2Abstract |
Objective |
To determine the risk of bacterial meningitis in infants aged 29-90 days with evidence of urinary tract infection (UTI).
Methods |
PubMed (MEDLINE), Embase, and the Cochrane Library were systematically searched for studies reporting rates of meningitis in infants aged 29-90 days with abnormal urinalysis or urine culture. Observational studies in infants with evidence of UTI who underwent lumbar puncture (LP) reporting age-specific event rates of bacterial meningitis and sterile cerebrospinal fluid pleocytosis were included. Prevalence estimates for bacterial meningitis in infants with UTI were pooled in a random effects meta-analysis.
Results |
Three prospective and 17 retrospective cohort studies were included in the meta-analysis. The pooled prevalence of concomitant bacterial meningitis in infants with UTI was 0.25% (95% CI, 0.09%-0.70%). Rates of sterile pleocytosis ranged from 0% to 29%. Variation in study methods precluded calculation of a pooled estimate for sterile pleocytosis. In most studies, the decision to perform a LP was up to the provider, introducing selection bias into the prevalence estimate.
Conclusions |
The risk of bacterial meningitis in infants aged 29-90 days with evidence of UTI is low. A selective approach to LP in infants identified as low risk for meningitis by other clinical criteria may be indicated.
Le texte complet de cet article est disponible en PDF.Keywords : serious bacterial infection, febrile infant, lumbar puncture, sterile pleocytosis
Abbreviations : CSF, ED, LP, UTI
Plan
| This work was prepared as part of our official U.S. government duties. However, the views expressed in this article are those of the authors and do not reflect the official policy or position of the United States Air Force, the United States Army, the Department of Defense, or the U.S. Government. The authors declare no conflicts of interest. |
|
| Portions of this study were presented as a poster at the Pediatric Academic Societies Annual Meeting, April 30-May 3, 2016, Baltimore, Maryland. |
Vol 212
P. 102 - septembre 2019 Retour au numéro
Article précédent
- Associations of Neonatal Noncardiac Surgery with Brain Structure and Neurodevelopment: A Prospective Case-Control Study
- Margaret M. Moran, Julia K. Gunn-Charlton, Jennifer M. Walsh, Jeanie L.Y. Cheong, Peter J. Anderson, Lex W. Doyle, Susan Greaves, Rod W. Hunt
- Seizure Rescue Medication Use among US Pediatric Epilepsy Providers: A Survey of the Pediatric Epilepsy Research Consortium
- Adam Wallace, Elaine Wirrell, Eric Payne
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?