{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:47:18Z","timestamp":1791848838244,"version":"4.3.4"},"reference-count":22,"publisher":"Microbiology Society","issue":"1","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["UL1TR002553"],"award-info":[{"award-number":["UL1TR002553"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold> Paediatric bacterial meningitis remains a costly disease, both financially and clinically.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Hypothesis\/Gap Statement<\/jats:bold>. Previous epidemiological and cost studies of bacterial meningitis (BM) have largely focused on adult populations or single pathogens. There have been few recent, large-scale studies of pediatric BM in the USA.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Aim.<\/jats:bold> We examined healthcare resource utilization (HCRU) and associated morbidity and mortality of community-acquired versus nosocomial bacterial infections in children across the USA.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methodology.<\/jats:bold> The IBM MarketScan Research databases were used to identify patients &lt;18\u2009years old admitted to USA hospitals from 2008 to 2015 with a primary diagnosis of BM. Cases were categorized as either community-acquired or nosocomial. HCRU, post-diagnosis neurosurgical procedures, 30-day in-hospital mortality, and complications were compared between groups. Multivariable regression adjusted for sex, age and Gram staining was used to compare costs of nosocomial versus community-acquired infections over time.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> We identified 1928 cases of paediatric BM without prior head trauma or neurological\/systemic complications. Of these, 15.4\u200a% were nosocomial and 84.6\u200a% were community-acquired infections. After diagnostic lumbar puncture (37.1\u200a%), the most common neurosurgical procedure was placement of ventricular catheter (12.6\u200a%). The 30-day complication rates for nosocomial and community-acquired infections were 40.5 and 45.9\u200a%, respectively. The most common complications were hydrocephalus (20.8\u200a%), intracranial abscess (8.8\u200a%) and cerebral oedema (8.1\u200a%). The 30-day in-hospital mortality rates for nosocomial and community-acquired infections were 2.7 and 2.8\u200a%, respectively.<\/jats:p>\n               <jats:p>Median length of admission was 14.0\u2009days (Q1: 7 days, Q3: 26 days). Median 90-day cost was $40\u200a861 (Q1: $11\u200a988, Q3: $114,499) for the nosocomial group and $56\u200a569 (Q1: $26\u200a127, Q3: $142\u200a780) for the community-acquired group. In multivariable regression, the 90-day post-diagnosis total costs were comparable between groups (cost ratio: 0.89; 95\u200a%\u2009CI: 0.70 to 1.13), but at 2\u2009years post-diagnosis, the nosocomial group was associated with 137\u200a% higher costs (CR: 2.37, 95\u200a%\u2009CI: 1.51 to 3.70).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> In multivariable analysis, nosocomial infections were associated with significantly higher long-term costs up to 2\u2009years post-infection. Hydrocephalus, intracranial epidural abscess and cerebral oedema were the most common complications, and lumbar punctures and ventricular catheter placement were the most common neurosurgical procedures. This study represents the first nation-wide, longitudinal comparison of the outcomes and considerable HCRU of nosocomial versus community-acquired paediatric BM, including characterization of complications and procedures contributing to the high costs of these infections.<\/jats:p>","DOI":"10.1099\/jmm.0.001276","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T16:28:28Z","timestamp":1605716908000},"source":"Crossref","is-referenced-by-count":12,"title":["Paediatric bacterial meningitis in the USA: outcomes and healthcare resource utilization of nosocomial versus community-acquired infection"],"prefix":"10.1099","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2322-5478","authenticated-orcid":false,"given":"Syed M.","family":"Adil","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Hodges","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0907-1254","authenticated-orcid":false,"given":"Lefko T.","family":"Charalambous","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Kiyani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beiyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6060-8443","authenticated-orcid":false,"given":"Hui-Jie","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8735-9064","authenticated-orcid":false,"given":"Beth A.","family":"Parente","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Perfect","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanand P.","family":"Lad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005384"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.17.2048"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ368"},{"key":"R4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/INF.0b013e3181ef25f7","article-title":"Long-term sequelae of childhood bacterial meningitis: an underappreciated problem","volume":"30","author":"Chandran","year":"2011","journal-title":"Pediatr Infect Dis J"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001603"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.697"},{"key":"R7","article-title":"Meningitis-Related Hospitalizations in the United States, 2006: Statistical Brief #57. 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