Meningitis caused by extended-spectrum ß-lactamase-producing Escherichia coli in infants in France: a case series.
JAC Antimicrob Resist
; 5(2): dlad042, 2023 Apr.
Article
in En
| MEDLINE
| ID: mdl-37051190
ABSTRACT
Objectives:
We report the first case series focusing on clinical and biological characteristics of meningitis caused by ESBL-producing Escherichia coli in infants.Methods:
Between 2001 and 2020, data on all cases of E. coli meningitis were prospectively collected from a network of 259 paediatric wards and 168 microbiology laboratories in France. We analysed the clinical and biological characteristics, short-term complications and long-term sequelae of ESBL-producing E. coli meningitis cases in patients <6â months old.Results:
In total, 548 cases of E. coli paediatric meningitis were reported. ESBL-producing E. coli represented 12 (2.2%) cases. We included 10 patients aged <6â months old. Eight (80%) patients presented at least one sign of clinical severity six needed mechanical ventilation, three presented signs of shock and one was in a coma. The overall short-term prognosis was good, with only one meningitis-attributed death in the first hours of care. All surviving children received carbapenems for a median of 21â days (range 9-28). Two relapses occurred, including one in a patient who received only 14â days of imipenem. We reported no long-term sequelae at a median follow-up of 20â months.Conclusions:
Meropenem seems to be the treatment of choice for ESBL-producing E. coli meningitis in children and needs to be given as early as possible (<48â h) and for at least 21â days. Maternal colonization or infection with ESBL-producing Enterobacteriaceae needs to be reported to the neonatal or paediatric ICU team, in order to adapt the empirical antibiotic therapy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Prognostic_studies
Language:
En
Journal:
JAC Antimicrob Resist
Year:
2023
Document type:
Article
Affiliation country: