Some selected abstract:

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Garges HP, Moody MA, Cotten CM, Smith PB, Tiffany KF, Lenfestey R, Li JS, Fowler VG Jr, Benjamin DK Jr.  Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics. 2006 Apr;117(4):1094-100.

Pediatrics, Duke University, Durham, North Carolina, USA.

BACKGROUND: Meningitis is a substantial cause of morbidity and mortality in neonates. Clinicians frequently use the presence of positive blood cultures to determine whether neonates should undergo lumbar puncture. Abnormal cerebrospinal fluid (CSF) parameters are often used to predict neonatal meningitis and determine length and type of antibiotic therapy in neonates with a positive blood culture and negative CSF culture. METHODS: We evaluated the first lumbar puncture of 9111 neonates at > or =34 weeks' estimated gestational age from 150 NICUs, managed by the Pediatrix Medical Group, Inc. CSF culture results were compared with results of blood cultures and CSF parameters (white blood cells [WBCs], glucose, and protein) to establish the concordance of these values in culture-proven meningitis. CSF cultures positive for coagulase-negative staphylococci and other probable contaminants, as well as fungal and viral pathogens, were excluded from analyses. RESULTS: Meningitis was confirmed by culture in 95 (1.0%) neonates. Of the 95 patients with meningitis, 92 had a documented blood culture. Only 57 (62%) of 92 patients had a concomitant-positive blood culture; 35 (38%) of 92 had a negative blood culture. In neonates with both positive blood and CSF cultures, the organisms isolated were discordant in 2 (3.5%) of 57 cases. In each case, the CSF pathogen required different antimicrobial therapy than the blood pathogen. For culture-proven meningitis, CSF WBC counts of >0 cells per mm3 had sensitivity at 97% and specificity at 11%. CSF WBC counts of >21 cells per mm3 had sensitivity at 79% and specificity at 81%. Culture-proven meningitis was not diagnosed accurately by CSF glucose or by protein. CONCLUSIONS: Neonatal meningitis frequently occurs in the absence of bacteremia and in the presence of normal CSF parameters. No single CSF value can reliably exclude the presence of meningitis in neonates. The CSF culture is critical to establishing the diagnosis of neonatal meningitis.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

14774.  Centers for Disease Control and Prevention (CDC). Survey of lymphocytic choriomeningitis virus diagnosis and testing--Connecticut, 2005. MMWR Morb Mortal Wkly Rep. 2006 Apr 14;55(14):398-9.

14775.  Eisenhut M. Comment on "Pretreatment intracerebral and peripheral blood immune responses in Vietnamese adults with tuberculous meningitis: diagnostic value and relationship to disease severity and outcome". J Immunol. 2006 May 1;176(9):5137.

14776.  Hsiao AL, Chen L, Baker MD. Incidence and predictors of serious bacterial infections among 57- to 180-day-old infants. Pediatrics. 2006 May;117(5):1695-701.

14777.  Jones SE, Belsley NA, McLoud TC, Mullins ME. Rheumatoid meningitis: radiologic and pathologic correlation. AJR Am J Roentgenol. 2006 Apr;186(4):1181-3.

14778.  Odetola FO, Tilford JM, Davis MM. Variation in the use of intracranial-pressure monitoring and mortality in critically ill children with meningitis in the United States. Pediatrics. 2006 Jun;117(6):1893-900.

14779.  Offiah CE, Turnbull IW. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patients. Clin Radiol. 2006 May;61(5):393-401.

14780.  Weisfelt M, de Gans J, van der Poll T, van de Beek D.  Pneumococcal meningitis in adults: new approaches to management and prevention. Lancet Neurol. 2006 Apr;5(4):332-42.

Pathogenesis:

14781.  Yao K, Mandel M, Akyani N, Maynard K, Sengamalay N, Fotheringham J, Ghedin E, Kashanchi F, Jacobson S. Differential HHV-6A gene expression in T cells and primary human astrocytes based on multi-virus array analysis. Glia. 2006 Jun;53(8):789-98.

Vaccines:

14782.  Guirola M, Carmenate T, Menendez T, Alvarez A, Gonzalez S, Guillen G. Comparison of three ELISA protocols to measure antibody responses elicited against serogroup C meningococcal polysaccharide in mouse, monkey and human sera. J Microbiol Methods. 2006 Apr;65(1):135-43.

14783.  Mehlhorn AJ, Balcer HE, Sucher BJ. Update on prevention of meningococcal disease: focus on tetravalent meningococcal conjugate vaccine. Ann Pharmacother. 2006 Apr;40(4):666-73.

14784.  Ostergaard C, O'Reilly T, Brandt C, Frimodt-Moller N, Lundgren JD. Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis. BMC Infect Dis. 2006 Apr 27;6:78.

14785.  Wilson-Clark SD, Squires S, Deeks S; Centers for Disease Control and Prevention (CDC). Bacterial meningitis among cochlear implant recipients--Canada, 2002. MMWR Morb Mortal Wkly Rep. 2006 Apr 28;55 Suppl 1:20-4.