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Bacterial meningitis among children with cochlear implants beyond 24 months after implantation

Krista R Biernath1, Jennita Reefhuis, Cynthia G Whitney

  • 1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. kbiernath@cdc.gov

Pediatrics
|January 5, 2006
PubMed

Insights

Children with cochlear implants, especially those with positioners, face a continued high risk of bacterial meningitis for over two years post-implantation. Ongoing vigilance and vaccination are crucial for these pediatric patients.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Disease Epidemiology
  • Biomedical Engineering

Background:

  • Cochlear implants are used by over 11,000 US children with severe-to-profound hearing loss.
  • A prior study found pneumococcal meningitis incidence >30 times higher in pediatric cochlear implant recipients.
  • Children with cochlear implants with positioners had a higher risk of bacterial meningitis for up to 24 months post-implantation.

Purpose of the Study:

  • To determine if the elevated risk of bacterial meningitis in pediatric cochlear implant recipients extends beyond 24 months.
  • To update incidence rates of bacterial meningitis in this vulnerable population.

Main Methods:

  • The study cohort included 4,265 children (<6 years at implantation) who received cochlear implants between 1997 and 2002.
  • Updated incidence rates were calculated, focusing on time since implantation.
  • New meningitis cases were identified and analyzed.

Main Results:

  • Twelve new meningitis episodes were identified in 12 children; 11 had implants with positioners, and 2 children died.
  • Six meningitis episodes occurred more than 24 months after implantation.
  • The incidence of bacterial meningitis >=24 months post-implantation was 450 cases/100,000 person-years for children with positioners, versus zero for those without.

Conclusions:

  • The increased risk of bacterial meningitis persists beyond 24 months post-implantation, particularly for children with positioners.
  • Healthcare providers and parents must maintain vigilance for bacterial infections in children with cochlear implants.
  • Current vaccination recommendations apply to all children with cochlear implants, regardless of device type.
Abstract

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