Bacterial Meningitis: a study in neonates

Professor Paul Heath, St. George's, University of London

Working with Dr. Ifeanyichukwu Okike, Professor Heath aims to identify ways in which the treatment of bacterial meningitis in newborns can be improved.

Newborn babies run a higher risk of contracting meningitis than any other age group. Although the use of antibiotics has improved the chances of survival, this remains a very serious illness and, with no vaccine available to protect against the main causes of neonatal meningitis, it is even more important to find ways of improving treatment.

Please visit the official project website for further information.

Meningitis UK is currently working in collaboration with Professor Heath and Dr Okike from St. George's, London, who are leading an investigation to determine the best treatment options for all forms of neonatal bacterial meningitis, the most common being Streptococcal Group B Meningitis (strep B meningitis). They are seeking to answer questions relating to the number and nature of cases, as well as establishing what treatment was given and whether or not it was successful.

The success of this project depends on being able to gather information about as many neonatal bacterial meningitis cases as possible, as this would create an accurate picture of the current situation thus resulting treatment improvements would be of wider benefit. Although Meningitis UK is not funding this research, the charity’s aim is to increase awareness and enable people to share their experience in order to inform future treatment improvements.

Who can participate?

If your baby was diagnosed with bacterial meningitis when they were younger than 90 days from July 2010, you can help. Simply call Meningitis UK on 0117 947 63 20 and a member of staff will be able to explain the study, and, with your consent, take the following details:

- Baby's name & date of birth
- Date of hospital admission
- Hospital number & NHS number (if known)
- Name of treating hospital
- Name of responsible paediatrician (if known)

This information will then be sent to Dr Okike to be used in part I and/or part II of the study, in accordance with your wishes.

Part I

This part looking at the number of cases and causative organisms has now ended and the results will be made available in the near future

Part II

Dr Okike will use your information to contact the paediatrician at the treating hospital. The paediatrician will then contact you directly to fill in a questionnaire regarding your experiences both before and during hospital admission. If you wish to, you can complete a return slip that we can use to contact you about the study.

You will not need to travel to London and all information will be strictly confidential.

The information generated by this study will provide an excellent basis for evaluating and improving existing 'treatment' options for neonatal meningitis.

Recruitment to this project will continue until June 2012.

The following update is based on the poster presentation given at the Meningitis Research Foundation Conference in November 2011.

During the study period 484 cases were notified via the British Paediatric Surveillance Unit. Cases notified via sources other than the BPSU (including from Meningitis UK) are currently being verified and de-duplicated. The following data represents the first 200 cases:

- Cases were reported from 125 different hospitals (England 86.5%, Wales 5%, Scotland 2.5%, Northern Ireland 3% and Republic of Ireland 3%)

- Most babies were admitted from home

- The most common presenting signs were poor feeding (69%), irritability (65%), lethargy (61%) and a fever greater than 38'c (54%)

- Lumbar puncture was performed in 94.5% of babies

- 75% of the cases had an organism isolated fromt he CSF or blood cultures; 50% of these were Group B Streptococcus.

Click here to read the latest update from the team.

page updated 06.03.12

The outcomes of this project will appear here after completion.

Bacterial meningitis in babies under 90 days of age: the current burden of disease

Professor Paul Heath, St. George's, University of London

Working with Dr. Ifeanyichukwu Okike, Professor Heath aims to identify ways in which the treatment of bacterial meningitis in newborns can be improved.

Bacterial meningitis is associated with significant mortality and morbidity in newborn infants. Apart from leading to death in about 10% of the cases, up to half of the babies are left with devastating disabilities which not only is burden to the family but also to the healthcare system. This study aims to identify the number of cases, the causative agents and the antibiotics that are used to treat them. It also aims to find out the complications that occur. Based on current practice and the best available evidence, the study will produce a guideline for management of meningitis in babies.

Please visit the official project website for further information.

Parents/carers of babies who had bacterial meningitis when they were 90 days or less, from July 2010, can contact the following parent support charities (Meningitis Research Foundation, Meningitis Trust, Meningitis UK and Group B Strep Support Group). At the point of contact, the charities will inform parents of the study. If the parents give their verbal consent then the charities will complete a form that will be faxed or emailed to the study research fellow (CRF). This form will include: Name of baby, Date of birth, NHS and or Hospital number, date of admission, Name of hospital, and name of responsible Paediatrician.

Once this form is received, the study CRF will then send a standard letter to the responsible Paediatrician to verify the case and complete a standard questionnaire. The CRF will also go to the local hospital and review the medical notes. No contact will be made by the research team with parents directly.

If consent is given, parents/carers can also participate in the second part of the study, in which the treating paediatrician will send parents/carers a questionnaire asking them to describe the events leading up to the illness through to the hospital admission. The questionnaire will ask some questions about the family as well and should take approximately 30 minutes to complete. There will be no blood tests or clinical procedures.

Recruitment to this project will continue until June 2012

The following update is based on the poster presentation given at the Meningitis Research Foundation Conference in November 2011.

- Cases were reported from 125 different hospitals (England 86.5%, Wales 5%, Scotland 2.5%, Northern Ireland 3% and Republic of Ireland 3%)

- 57% were male

- 80% were classified as 'any white background'

- The median age was 13 days

- The median gestational age at birth was 39 weeks

- Most babies were admitted from home

- The most common presenting signs were poor feeding (69%), irritability (65%), lethargy (61%) and a fever greater than 38'c (54%)

- Lumbar puncture was performed in 94.5% of babies

- 75% of the cases had an organism isolated fromt he CSF or blood cultures; 50% of these were Group B Streptococcus and 10% Streptococcus pneumoniae

- Empirical 3rd generation cephalosporins was used in 75% and gentamicin in 43% of cases.

- Case fatality at time of reporting was 7.5%