New research finds that most babies who get bacterial meningitis within the first 90 days of life get it from E. Coli or Group B Strep. Each of these two bacteria accounts for roughly one-third of bacterial meningitis cases.
Why is this important?
There are two considerations that need to be taken into account: the severity of meningitis, which can cause brain damage and brain inflammation, and treatment type.
Meningitis Can Cause Severe Brain Damage if Treated Improperly or Left Untreated
Bacterial meningitis occurs when the membranes surrounding the baby’s brain and spinal cord become infected with either a virus or a bacteria. The body’s immune system triggers an inflammatory response to the pathogens; this inflammatory response can additionally damage cells in the brain, causing cognitive delays, cerebral palsy and other disabilities. If meningitis is not properly treated, it can result in a baby’s death.
Meningitis rates from Group B Strep are significant, with a relatively high 14% mortality rate and a high burden of disability. The striking thing is that Group B Strep meningitis is easily preventable by first diagnosing the mother using a simple and noninvasive swab test and then providing her with antibiotic treatments during labor to prevent transmission to the baby. Babies exposed to pathogenic bacteria during labor should receive antibiotics to prevent infection-related brain damage.
Choosing Antibiotics to Treat Group B Strep or E. Coli Meningitis in Newborns
There have recently been concerns about antibiotic resistance in the treatment of certain bacterial infections – antibiotics must be carefully selected to treat the bacterial infection and minimize the risk of resistance. Of the newborns studied who contracted meningitis within the first 6 days of life, two had bacterial infections that showed signs of resistance to both ampicillin and gentamycin. Further, of the 60 newborns who had meningitis between days 7 and 60 of life, six had infections that cefotaxime (another common antibiotic) was unsuitable for treating. In this specific study, eight babies died, and nearly ¾ had documented health effects stemming from the infection.
The researchers suggest that the antibiotic best suited to treating infants with bacterial meningitis is a third-generation cephalosporin (in combination with ampicillin for at least the first month). They suggested using a carbapenem instead of cephalosporin in the presence of gram-negative bacteria.
The Takeaway
Bacterial meningitis is a potentially deadly infection in newborns and must be promptly and appropriately treated. Babies with infections of the membranes surrounding the brain and spinal cord are at very high risk of having brain damage and adverse health effects. Medical professionals should promptly and appropriately treat and diagnose cases of meningitis and investigate suspected cases of meningitis. Parents may seek the help of a medical professional if their child begins showing signs of potential meningitis infection, including:
| Stiff neck | Inactivity/lethargy | Apnea (periodic cessation of breathing) |
| Respiratory issues | High or low body temperature | Poor feeding |
| irritability | Abnormal skin color | Low blood pressure |
| Seizures |
Source:
- Ouchenir L et al. The Epidemiology, Management, and Outcomes of Bacterial Meningitis in Infants. Pediatrics Jun 2017, e20170476; DOI: 10.1542/peds.2017-0476
- News: E. Coli, GBS Account for 64% of Neonatal Bacterial Meningitis
Related Reading:
- Neonatal Sepsis and Meningitis
- Group B Strep
- Infections During Pregnancy
- Neonatal Birth Injury and Infection
Additional Research
