Paediatric Emergency and Infectious Diseases Unit

Saint-André-lez-Lille, France

Paediatric Emergency and Infectious Diseases Unit

Saint-André-lez-Lille, France

Time filter

Source Type

Alexandre C.,University of Lille Nord de France | Dubos F.,University of Lille Nord de France | Dubos F.,Paediatric Emergency and Infectious Diseases Unit | Courouble C.,Dr Schaffner Hospital | And 3 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2010

Aim: To determine whether the recent emergence of nonvaccine pneumococcal serotypes has affected the incidence of pneumococcal meningitis in children a few years after the introduction of the heptavalent pneumococcal conjugate vaccine. Methods: We conducted a multicentre retrospective cohort study from 2005 to 2008 in all hospitals with paediatric units in northern France. It included all patients <18 years of age who were admitted for laboratory-confirmed pneumococcal meningitis during the study period. Data were collected from medical files and laboratory records at each hospital and compared with the regional hospital discharge codes. We assessed global and age-specific incidence rates of pneumococcal meningitis from 2005 through 2008, compared them with those from the prevaccine era (2000-2002) and evaluated pneumococcal serotypes. Results: In all, 41 cases were found during the study period. The incidence rate of pneumococcal meningitis varied from 0.8 / 100 000 children <18 years in 2005 to 1.8 / 100 000 children in 2008 (2.2-fold increase, p = 0.06); and from 1.8 to 11.9 / 100 000 children <2 years (6.5-fold increase, p = 0.004). This increase was caused by nonvaccine pneumococcal serotypes. Conclusion: The incidence of pneumococcal meningitis in infants has rebounded in northern France during the pneumococcal conjugate vaccine programme, with the emergence of nonvaccine pneumococcal serotypes. © 2010 The Author(s)/Journal Compilation.


Najaf-Zadeh A.,University of Lille Nord de France | Najaf-Zadeh A.,Paediatric Emergency and Infectious Diseases Unit | Dubos F.,University of Lille Nord de France | Dubos F.,Paediatric Emergency and Infectious Diseases Unit | And 10 more authors.
PLoS ONE | Year: 2013

Background: Of major concern in any febrile child presenting with a seizure is the possibility of bacterial meningitis (BM). We did a systematic review to estimate the risk of BM among various subgroups of young children with a first seizure in the context of fever, and to assess the utility of routine lumbar puncture (LP) in children with an apparent first FS. Methods/Principal Findings: MEDLINE, INIST, and the COCHRANE Library databases were searched from inception to December 2011 for published studies, supplemented by manual searches of bibliographies of potentially relevant articles and review articles. Studies reporting the prevalence of BM in young children presenting to emergency care with a first: i) "seizure and fever", ii) apparent simple FS, and iii) apparent complex FS were included. Fourteen studies met the inclusion criteria. In children with a first "seizure and fever", the pooled prevalence of BM was 2.6% (95% CI 0.9-5.1); the diagnosis of BM might be suspected from clinical examination in 95% of children >6 months. In children with an apparent simple FS, the average prevalence of BM was 0.2% (range 0 to 1%). The pooled prevalence of BM among children with an apparent complex FS was 0.6% (95% CI 0.2-1.4). The utility of routine LP for diagnosis of CNS infections requiring immediate treatment in children with an apparent first FS was low: the number of patients needed to test to identify one case of such infections was 1109 in children with an apparent first simple FS, and 180 in those with an apparent first complex FS. Conclusion: The values provided from this study provide a basis for an evidence-based approach to the management of different subgroups of children presenting to emergency care with a first seizure in the context of fever. © 2013 Najaf-Zadeh et al.

Loading Paediatric Emergency and Infectious Diseases Unit collaborators
Loading Paediatric Emergency and Infectious Diseases Unit collaborators