{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:09:49Z","timestamp":1790701789775,"version":"4.1.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Late-onset meningitis (LOM) has been associated with adverse neurodevelopmental outcomes in children born extremely preterm.<\/jats:p><\/jats:sec>Objective<\/jats:title>To report the incidence of LOM during birth hospitalization and neurodevelopmental outcomes at 18 to 26 months\u2019 corrected age.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study is a secondary analysis of a multicenter prospective cohort of children born at 22 to 26 weeks\u2019 gestation between 2003 and 2017 with follow-up from 2004 to 2021. The study was conducted at 25 Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Culture-confirmed LOM.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Incidence and microbiology of LOM (2003-2017); lumbar puncture (LP) performance in late-onset sepsis (LOS) evaluations (2011-2017); composite outcome of death or neurodevelopmental impairment (NDI; 2004-2021).<\/jats:p><\/jats:sec>Results<\/jats:title>Among 13\u202f372 infants (median [IQR] gestational age, 25.4 [24.4-26.1] weeks; 6864 [51%] boys), LOM was diagnosed in 167 (1%); LOS without LOM in 4564 (34%); and neither LOS nor LOM in 8641 (65%). The observed incidence of LOM decreased from 2% (95% CI, 1%-3%) in 2003 to 0.4% (95% CI, 0.7%-1.0%) in 2017 (P<\/jats:italic>\u2009&amp;lt;\u2009.001). LP performance in LOS evaluations decreased from 36% (95% CI, 33%-40%) in 2011 to 24% (95% CI, 21%-27%) in 2017 (P<\/jats:italic>\u2009&amp;lt;\u2009.001). Among infants with culture-confirmed LOS, LP performance decreased from 58% (95% CI, 51%-65%) to 45% (95% CI, 38%-51%; P<\/jats:italic>\u2009=\u2009.008). LP performance varied by center among all LOS evaluations (10%-59%, P<\/jats:italic>\u2009&amp;lt;\u2009.001) and among those with culture-confirmed LOS (23%-79%, P<\/jats:italic>\u2009&amp;lt;\u2009.001). LOM occurred in the absence of concurrent LOS in 27 of 167 cases (16%). The most common LOM isolates were coagulase-negative Staphylococcus<\/jats:italic> (98 [59%]), Candida albicans<\/jats:italic> (38 [23%]), and Escherichia coli<\/jats:italic> (27 [16%]). Death or NDI occurred in 22 of 46 children (48%) with LOM due to coagulase-negative Staphylococcus<\/jats:italic>, 43 of 67 (64%) due to all other bacterial pathogens, and 26 of 33 (79%) due to fungal pathogens. The adjusted relative risk of death or NDI was increased among children with LOM (aOR, 1.53; 95% CI, 1.04-2.25) and among those with LOS without LOM (aOR, 1.41; 95% CI, 1.29-1.54) compared with children with neither infection.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, LP was performed with decreasing frequency, and the observed incidence of LOM also decreased. Both LOM and LOS were associated with increased risk of death or NDI; risk varied by LOM pathogen. The full association of LOM with outcomes of children born extremely preterm may be underestimated by current diagnostic practices.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.45826","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T16:01:28Z","timestamp":1670515288000},"page":"e2245826","source":"Crossref","is-referenced-by-count":23,"title":["Incidence of and Neurodevelopmental Outcomes After Late-Onset Meningitis Among Children Born Extremely Preterm"],"prefix":"10.1001","volume":"5","author":[{"given":"Jane E.","family":"Brumbaugh","sequence":"first","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara 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