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A Meta-analysis of the Rates of Listeria monocytogenes and Enterococcus in Febrile Infants

Rianna Leazer1, Amy M Perkins2, Kyrie Shomaker2

  • 1Department of Pediatrics, Children's Hospital of the King's Daughters and Eastern Virginia Medical School, Norfolk, Virginia rianna.leazer@chkd.org.

Hospital Pediatrics
|March 17, 2016
PubMed
Abstract

Insights

Serious bacterial infections (SBI) caused by Listeria monocytogenes and Enterococcus species in febrile infants are rare. Current data suggest clinicians may consider revising empirical antibiotic choices for young infants with fever.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Epidemiology of serious bacterial infections (SBI) in infants has shifted.
  • Original empirical antibiotic recommendations for febrile infants may need updating.

Purpose of the Study:

  • To determine the prevalence of SBI caused by Listeria monocytogenes and Enterococcus species in infants.
  • To inform potential changes in empirical antibiotic treatment guidelines.

Main Methods:

  • Conducted a literature search for SBI, L. monocytogenes, and Enterococcus spp. infections.
  • Included US-based studies published from January 1998 to June 2014 on infants ≤90 days.
  • Performed meta-analysis to calculate pathogen prevalence in blood, cerebrospinal fluid, and urine cultures.

Main Results:

  • Analyzed 16 studies involving over 52,000 cultures.
  • Weighted prevalence for L. monocytogenes bacteremia was 0.03%; Enterococcus spp. bacteremia was 0.09%.
  • Weighted prevalence for Enterococcus spp. UTI was 0.28%; no L. monocytogenes UTIs were reported. Meningitis rates were low for both pathogens.

Conclusions:

  • SBI due to L. monocytogenes and Enterococcus species in febrile infants is uncommon.
  • Findings suggest a potential need to revise empirical antibiotic strategies for febrile infants.
  • Limitations include possible reporting bias and incomplete study retrieval.

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