{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:47:00Z","timestamp":1792421220267,"version":"4.5.0"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>The pathogens that cause bacterial meningitis in infants and their antimicrobial susceptibilities may have changed in this era of increasing antimicrobial resistance, use of conjugated vaccines, and maternal antibiotic prophylaxis for group B Streptococcus (GBS). The objective was to determine the optimal empirical antibiotics for bacterial meningitis in early infancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This was a cohort study of infants &amp;lt;90 days of age with bacterial meningitis at 7 pediatric tertiary care hospitals across Canada in 2013 and 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>There were 113 patients diagnosed with proven meningitis (n = 63) or suspected meningitis (n = 50) presented at median 19 days of age, with 63 patients (56%) presenting a diagnosis from home. Predominant pathogens were Escherichia coli (n = 37; 33%) and GBS (n = 35; 31%). Two of 15 patients presenting meningitis on day 0 to 6 had isolates resistant to both ampicillin and gentamicin (E coli and Haemophilus influenzae type B). Six of 60 infants presenting a diagnosis of meningitis from home from day 7 to 90 had isolates, for which cefotaxime would be a poor choice (Listeria monocytogenes [n = 3], Enterobacter cloacae, Cronobacter sakazakii, and Pseudomonas stutzeri). Sequelae were documented in 84 infants (74%), including 8 deaths (7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>E coli and GBS remain the most common causes of bacterial meningitis in the first 90 days of life. For empirical therapy of suspected bacterial meningitis, one should consider a third-generation cephalosporin (plus ampicillin for at least the first month), potentially substituting a carbapenem for the cephalosporin if there is evidence for Gram-negative meningitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2017-0476","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T05:10:14Z","timestamp":1496985014000},"source":"Crossref","is-referenced-by-count":185,"title":["The Epidemiology, Management, and Outcomes of Bacterial Meningitis in Infants"],"prefix":"10.1542","volume":"140","author":[{"given":"Lynda","family":"Ouchenir","sequence":"first","affiliation":[{"name":"Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Renaud","sequence":"additional","affiliation":[{"name":"Centre hospitalier universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Bitnun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andree-Anne","family":"Boisvert","sequence":"additional","affiliation":[{"name":"Montreal Children\u2019s Hospital, McGill University, Montreal, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"McDonald","sequence":"additional","affiliation":[{"name":"Montreal Children\u2019s Hospital, McGill University, Montreal, Quebec, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bowes","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Brophy","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Barton","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, Western University, London, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Ting","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Roberts","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hawkes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stollery Children\u2019s Hospital, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan L.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stollery Children\u2019s Hospital, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,7,1]]},"reference":[{"issue":"1","key":"2021121014413595800_B1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.clp.2014.10.004","article-title":"Bacterial meningitis in infants.","volume":"42","author":"Ku","year":"2015","journal-title":"Clin Perinatol"},{"issue":"10","key":"2021121014413595800_B2","doi-asserted-by":"crossref","first-page":"e150","DOI":"10.1093\/cid\/ciu514","article-title":"Incidence, etiology, and outcome of bacterial meningitis in infants aged &lt;90 days in the United kingdom and Republic of Ireland: prospective, enhanced, national population-based surveillance.","volume":"59","author":"Okike","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"6","key":"2021121014413595800_B3","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jmii.2011.12.034","article-title":"Factors for poor prognosis of neonatal bacterial meningitis in a medical center in Northern Taiwan.","volume":"45","author":"Lin","year":"2012","journal-title":"J Microbiol Immunol Infect"},{"issue":"3","key":"2021121014413595800_B4","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/INF.0b013e3181fab1e7","article-title":"Neonatal bacterial meningitis: 444 cases in 7 years.","volume":"30","author":"Gaschignard","year":"2011","journal-title":"Pediatr Infect Dis J"},{"issue":"21","key":"2021121014413595800_B5","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1056\/NEJMoa1005384","article-title":"Bacterial meningitis in the United States, 1998-2007.","volume":"364","author":"Thigpen","year":"2011","journal-title":"N Engl J Med"},{"issue":"10","key":"2021121014413595800_B6","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S1701-2163(15)30818-5","article-title":"The prevention of early-onset neonatal group B streptococcal disease.","volume":"35","author":"Money","year":"2013","journal-title":"J Obstet Gynaecol Can"},{"key":"2021121014413595800_B7","unstructured":"Centers for Disease Control and Prevention. 2010 guidelines for the prevention of perinatal group b streptococcal disease. 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