Neonatal and Infant Meningitis

Question 1

What form of neonatal and infant meningitis is Streptococcus agalactiae?

Answer 1

Bacterial, gram positive

Question 2

What are the most common modes of transmission for Streptococcus agalactiae?

Answer 2

Vertical (during birth)

Question 3

What are the virulence factors for Streptococcus agalactiae?

Answer 3

Capsule

Question 4

How do you culture/diagnose Streptococcus agalactiae?

Answer 4

Culture mother’s genital tract on blood agar; CSF culture of neonate

Question 5

How do you prevent Streptococcus agalactiae infection?

Answer 5

Culture and treatment of mother

Question 6

How do you treat Streptococcus agalactiae infection?

Answer 6

Penicillin G plus amingolycosides

Question 7

What are the distinctive features of Streptococcus agalactiae?

Answer 7

Most common; positive culture of mother confirms diagnosis

Question 8

What are the epidemiological features of Streptococcus agalactiae?

Answer 8

Before intrapartum antibiotics introduced in 1996; 1.8 cases per 1,000 live births; after intrapartum antibiotics: 0.32 case per 1,000 live births

Question 9

What form of neonatal and infant meningitis is Escherichia coli, strain K1?

Answer 9

Bacterial, gram-negative

Question 10

What are the most common modes of transmission for Escherichia coli, strain K1?

Answer 10

Vertical (during birth)

Question 11

What are the virulence factors for Escherichia coli, strain K1?

Answer 11

–

Question 12

How do you culture/diagnose Escherichia coli, strain K1?

Answer 12

CSF Gram stain/ culture

Question 13

How do you prevent Escherichia coli, strain K1 infection?

Question 14

How do you treat Escherichia coli, strain K1 infection?

Answer 14

Ceftazidime or cefepime +/- gentamicin

Question 15

What are the distinctive features of Escherichia coli, strain K1?

Answer 15

Suspected if infant is premature

Question 16

What are the epidemiological features of Escherichia coli, strain K1?

Answer 16

Estimated at 0.2-5 per 1,000 live births; 20% of pregnant women colonized

Question 17

What form of neonatal and infant meningitis is Listeria monocytogenes?

Answer 17

Bacterial, gram-positive

Question 18

What are the most common modes of transmission for Listeria monocytogenes?

Answer 18

Vertical

Question 19

What are the virulence factors for Listeria monocytogenes?

Answer 19

Intracellular growth

Question 20

How do you culture/diagnose Listeria monocytogenes?

Answer 20

Cold enrichment, rapid methods

Question 21

How do you prevent Listeria monocytogenes infection?

Answer 21

Cooking food, avoiding unpasteurized dairy products

Question 22

How do you treat Listeria monocytogenes infection?

Answer 22

Ampicillin, trimethoprim-sulfamethoxazole

Question 23

What are the distictive factors for Listeria monocytogenes?

Answer 23

None

Question 24

What are the epidemiological factors for Listeria monocytogenes?

Answer 24

Mortality as high as 33% in symptomatic cases

Question 25

What form of neonatal and infant meningitis is Cronobacter sakazakii?

Answer 25

Bacteria, gram-negative

Question 26

What are the most common modes of transmission for Cronobacter sakazakii?

Answer 26

Vehicle (baby formula)

Question 27

What are the virulence factors for Cronobacter sakazakii?

Answer 27

Ability to survive dry conditions

Question 28

How do you culture/diagnose Cronobacter sakazakii?

Answer 28

Chromogenic differential agar or rapid detection kits

Question 29

How do you prevent Cronobacter sakazakii infection?

Answer 29

Safe preparation and use of, or avoidance of, powdered formul

Question 30

How do you treat Cronobacter sakazakii infection?

Answer 30

Begin with broad-spectrum drugs until susceptibilities determined

Question 31

What are the distinctive features of Cronobacter sakazakii?

Question 32

What are the epidemiological features of Cronobacter sakazakii?

Answer 32

Rare (a handful of documented cases in the United States annually) but deadly