Aujard, Yannick <br/><br/>
Bacterial meningitis in newborns 

 -  2025.<br/>							 
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<br/><br/> Bacterial meningitis in newborns is usually secondary to a bacterial translocation from the digestive tract to the bloodstream. The risk of meningeal invasion depends on: 1) specific virulence genes; 2) the bacterial load in the bloodstream; and 3) the level of humoral and cellular immune defenses. The initial bacteremia may also invade brain tissue or the subdural space, causing abscesses and/or empyemas. Lumbar puncture is performed based on clinical and biological risk factors but is not routinely indicated. Empiric antibiotic therapy must be bactericidal. In France, a combination of amoxicillin, cefotaxime, and an aminoglycoside is the most commonly used treatment until the pathogen is identified. Ciprofloxacin, which targets Gram-negative bacteria, and rifampicin, used against GBS, are treatments for brain abscesses. They can be added to the initial antibiotic therapy based on brain MRI results obtained after 5 to 7 days of treatment. The prognosis of bacterial meningitis in newborns is severe, with a mortality rate of 10% and neurological sequelae occurring in 25 to 50% of cases.