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Repeat lumbar punctures in infants with meningitis in the neonatal intensive care unit

R G Greenberg1, D K Benjamin, M Cohen-Wolkowiez

  • 1Department of Pediatrics, Duke University, Durham, NC, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|December 18, 2010
PubMed

Insights

Repeat positive cerebrospinal fluid (CSF) cultures in infants are common and significantly increase mortality risk. This finding highlights the importance of careful monitoring and management in neonatal intensive care units.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pediatrics

Background:

  • Neonatal meningitis requires prompt diagnosis and treatment.
  • Cerebrospinal fluid (CSF) cultures are crucial for identifying pathogens.
  • Repeat testing may be necessary to confirm eradication or persistent infection.

Purpose of the Study:

  • To analyze outcomes of infants with initial positive CSF cultures undergoing repeat lumbar puncture.
  • To identify clinical characteristics and outcomes associated with repeat positive CSF cultures.

Main Methods:

  • A cohort study was conducted across 150 neonatal intensive care units.
  • Infants with initial positive CSF cultures and subsequent repeat lumbar punctures were identified (1997-2004).
  • Outcomes were compared between infants with repeat positive and repeat negative CSF cultures.

Main Results:

  • 118 infants underwent repeat CSF cultures; 26 had repeat positive results.
  • Mortality was significantly higher in infants with repeat positive cultures (26%) compared to repeat negative cultures (7%).
  • A P-value of 0.02 indicated statistical significance.

Conclusions:

  • Repeat positive CSF cultures are a frequent occurrence in infants with initial positive cultures.
  • A second positive CSF culture is a significant indicator of increased mortality risk.
  • These findings underscore the need for vigilant follow-up in neonatal infections.
Abstract

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