{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:20:04Z","timestamp":1780503604084,"version":"3.54.1"},"reference-count":55,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["918.19.627"],"award-info":[{"award-number":["918.19.627"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to estimate the recurrence rate of culture-positive bacterial meningitis in children in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Nationwide surveillance study, using the database of the Netherlands Reference Laboratory for Bacterial Meningitis to identify patients with culture-positive bacterial meningitis during childhood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was based in the Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total of 9731 children with a first bacterial meningitis episode between 1 July 1987 and 30 June 2019 were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Recurrence was defined as a subsequent episode &gt;28 days, or caused by a different pathogen. Annual incidence and incidence rate ratios (IRRs) comparing the periods 1988\u20132003 and 2004\u20132019 were calculated. Predictors of recurrent meningitis were assessed using Cox proportional hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-three (0.6%) of the 9731 children with a first bacterial meningitis episode contracted recurrent meningitis.<jats:italic>Neisseria meningitidis<\/jats:italic>was the leading pathogen for first meningitis episodes (52%) and<jats:italic>Streptococcus pneumoniae<\/jats:italic>for recurrent episodes (52%). The median annual incidence of first episodes per 100 000 children decreased from 11.81 (IQR 11.26\u201317.60) in 1988\u20132003 to 2.60 (IQR 2.37\u20134.07) in 2004\u20132019 (IRR 0.25, 95% CI 0.23 to 0.26). The incidence of recurrences did not change: 0.06 (IQR 0.02\u20130.11) in 1988\u20132003 to 0.03 (IQR 0.00\u20130.06) in 2004\u20132019 (IRR 0.65, 95% CI 0.39 to 1.1). Age above 5 years (OR 3.6 (95% CI 1.5 to 8.3)) and a first episode due to<jats:italic>Escherichia coli<\/jats:italic>(OR 25.7 (95% CI 7.2 to 92.0)) were associated with higher risks of recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The recurrence rate of childhood bacterial meningitis in the Netherlands was 0.6%. While the incidence rate of first episodes decreased substantially, this was not the case for recurrent episodes. Older age and a first episode due to<jats:italic>E. coli<\/jats:italic>were associated with higher recurrence risks.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2023-077887","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T13:52:08Z","timestamp":1703944328000},"page":"e077887","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Recurrent bacterial meningitis in children in the Netherlands: a nationwide surveillance study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9466-3247","authenticated-orcid":false,"given":"Linde","family":"Snoek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel N","family":"van Kassel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik L H","family":"Koelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie","family":"van der Ende","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina M","family":"van Sorge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs C","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik","family":"van de Beek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3246-5083","authenticated-orcid":false,"given":"Merijn W","family":"Bijlsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"2023123005501703000_13.12.e077887.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61186-6"},{"key":"2023123005501703000_13.12.e077887.2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/S2352-4642(22)00155-9","article-title":"Short-term and long-term risk of mortality and neurodevelopmental impairments after bacterial meningitis during infancy in children in Denmark and the Netherlands: a nationwide matched cohort study","volume":"6","author":"Snoek","year":"2022","journal-title":"The Lancet Child & Adolescent Health"},{"key":"2023123005501703000_13.12.e077887.3","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/S0140-6736(21)00883-7","article-title":"Community-acquired bacterial meningitis","volume":"398","author":"van de Beek","year":"2021","journal-title":"Lancet"},{"key":"2023123005501703000_13.12.e077887.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1774"},{"key":"2023123005501703000_13.12.e077887.5","doi-asserted-by":"crossref","first-page":"16074","DOI":"10.1038\/nrdp.2016.74","article-title":"Community-acquired bacterial meningitis","volume":"2","author":"van de Beek","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2023123005501703000_13.12.e077887.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61187-8"},{"key":"2023123005501703000_13.12.e077887.7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MOP.0000000000000338","article-title":"Adverse consequences of neonatal antibiotic exposure","volume":"28","author":"Cotten","year":"2016","journal-title":"Curr Opin Pediatr"},{"key":"2023123005501703000_13.12.e077887.8","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.ncl.2018.06.007","article-title":"Acute community-acquired bacterial meningitis","volume":"36","author":"Figueiredo","year":"2018","journal-title":"Neurol Clin"},{"key":"2023123005501703000_13.12.e077887.9","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00070-09"},{"key":"2023123005501703000_13.12.e077887.10","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000417"},{"key":"2023123005501703000_13.12.e077887.11","doi-asserted-by":"publisher","DOI":"10.1086\/520682"},{"key":"2023123005501703000_13.12.e077887.12","doi-asserted-by":"crossref","unstructured":"Ter Horst L , Brouwer MC , van der Ende A , et al . 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