Neurological Complications in Neonatal and Infant Bacterial Meningitis: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background Bacterial meningitis in neonates and infants is associated with high morbidity and mortality. Theincidence of bacterial meningitis has decreased in developed countries due to the use of conjugatesvaccines but the incidence is still high in developing countries. Neurological complications afterbacterial meningitis in neonates and infants can cause long-term sequelae such as neurodevelopmentaldelay and motor and psychometric impairment. The aim of this study is to investigate the prevalence ofneurological complications in neonates and infants diagnosed with bacterial meningitis. Methods Systematic electronic searches were conducted in EMBASE, MEDINE, and Google Scholar from January2000 to December 2020 to identify relevant studies. The quality of studies was assessed using theNewcastle-Ottawa-Scale. The random-effect model was used to calculate the pooled prevalence. Results A total of 10 studies involving 1206 patients were included in this systematic review. Five studies wereconducted in developing countries while five studies were conducted in developed countries. Theoverall prevalence of neurological complications in neonates and infants was 39.0% (95% CI 0.28-0.51).The most common neurological complication was hydrocephalus (11.5%, n=139) followed by seizure(9.5%, n=114), intracranial haemorrhage (9.1%, n=110), subdural effusion (6.8%, n=82), ventriculitis(4.6%, n=55), brain abscesses (4.2%, n=51), and brain infarct (3.1%, n=37). The common organismsfrom cerebrospinal fluid culture or blood culture were Group B Streptococcus (n=260), Escherichia coli(n=124), coagulase-negative Staphylococcus (n=78), Haemophilus influenzae (n=16), Neisseriameningitidis (n=11), and Listeria monocytogenes (n=10). Conclusions Neurological complications are frequently developed in neonates and infants diagnosed with bacterialmeningitis. Awareness of neurological sequelae is essential for planning clinical management toimprove patient outcomes. Frequent clinical follow-up with comprehensive neurological anddevelopmental assessment is needed after the disease to identify any complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.028 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.031 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".