Concomitant bacterial meningitis and urinary tract infection in infants: a systematic review and meta-analysis
Abstract
INTRODUCTION
Febrile infants often undergo septic workups, with urinary tract infection (UTI) being the most common serious bacterial infection. However, lumbar puncture practices vary, and the rate of concurrent meningitis remains uncertain. This systematic review and meta-analysis aimed to determine the rate of concomitant bacterial meningitis in febrile infants with UTI.
METHODS
MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and conference proceedings from inception to August 2023 were searched. Included studies involved febrile infants ≤90 days old with UTI and no clear infection source, where ≥10 infants underwent lumbar puncture. Studies with localising symptoms of another diagnosis or premature infants were excluded. Studies were independently reviewed and data were extracted. Meta-analysis was performed using random-effects models with heterogeneity tests. Study quality was assessed via the Newcastle-Ottawa Scale.
RESULTS
Thirty-nine observational studies met the eligibility criteria. The prevalence of concomitant definite bacterial meningitis in febrile infants with UTI was 0.3% (95% confidence interval [CI] 0.1%-0.4%). Between-studies comparison suggested this rate may be higher in neonates (≤28 days) than older infants (29-90 days old) (pooled estimate 0.7%, 95% CI 0.3%-1.1% vs. 0.2%, 0.0%-0.3%), while within-studies comparison showed no risk difference between the two groups. No…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10 participants or records.
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