The Pediatric infectious disease journal
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Pediatr. Infect. Dis. J. · Dec 2008
Multicenter StudyRevisiting the need for vaccine prevention of late-onset neonatal group B streptococcal disease: a multistate, population-based analysis.
Intrapartum antibiotic prophylaxis for neonatal group B streptococcal disease (GBS) effectively prevents disease among infants <7 days old, but there are no prevention strategies for late-onset GBS disease (onset on days 7-89 of life). We describe trends in late-onset GBS over a 16-year period to characterize disease burden and estimate vaccine preventability. ⋯ The late-onset GBS disease burden remains substantial. A trivalent vaccine could be an effective prevention strategy. Because many cases were born preterm, reducing the opportunity for transplacental antibody transfer, adolescent immunization should be considered.
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Pediatr. Infect. Dis. J. · Dec 2008
Traumatic lumbar punctures in neonates: test performance of the cerebrospinal fluid white blood cell count.
Cerebrospinal fluid (CSF) findings are often used to diagnose meningitis in neonates given antibiotics before the lumbar puncture is performed. Traumatic lumbar punctures are common and complicate interpretation of CSF white blood cell counts. The purpose of this study is to evaluate the diagnostic utility of adjusting CSF white blood cell counts based on CSF and peripheral red blood cell counts. ⋯ Adjustment of CSF white blood cell counts to account for increased red cells does not improve diagnostic utility. Adjustment can result in loss of sensitivity with marginal gain in specificity. Adjustment of WBC counts in the setting of a traumatic lumbar puncture does not aid in the diagnosis of bacterial and fungal meningitis in neonates.