Paediatric sepsis and meningitis Epidemiology, outcomes and prevention

This summary provides an overview of the findings on recurrent bacterial meningitis, long-term outcomes after paediatric sepsis and meningitis, and strategies for preventing and treating neonatal infections, particularly Group B Streptococcus (GBS).
Part I addresses recurrent bacterial meningitis in children, with a focus on data from the Netherlands (1987-2019). The recurrence rate was found to be 0.6%, with Streptococcus pneumoniae as the leading pathogen. Despite a decrease in first episodes, recurrence rates remained stable over time. Older children and those initially infected by Escherichia coli (E. coli) had a higher recurrence risk. Vaccination strategies post-first episode could be beneficial.
Part II discusses the long-term impacts of paediatric bacterial meningitis before the age of one year. These children face increased risks of premature death and neurodevelopmental impairments (NDIs), especially after meningitis caused by Group B Streptococcus (GBS) and E. coli. The importance of better follow-up care and vaccination is highlighted.
Concerning GBS infections, preterm infants and boys are particularly vulnerable for mortality and NDIs, emphasizing the need for enhanced follow-up care and additional preventative approaches.
Part III explores prevention and treatment strategies for neonatal GBS infections. Current prevention guidelines have limitations, and alternative approaches, like the Kaiser Permanente neonatal early-onset sepsis calculator (EOSC), showed poor sensitivity in identifying early-onset disease. Promising strategies to improve prevention and treatment strategies include the use of genome sequencing and routine submission of GBS isolates. The role of breastfeeding and early exposure to GBS should be further explored. Last, collaborative efforts between human and animal GBS experts are crucial to monitor and mitigate potential animal and public health threats.