Article

Bacterial meningitis among children with cochlear implants beyond 24 months after implantation

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
PEDIATRICS (Impact Factor: 5.3). 02/2006; 117(2):284-9. DOI: 10.1542/peds.2005-0824
Source: PubMed

ABSTRACT More than 11000 children in the United States with severe-to-profound hearing loss have cochlear implants. A 2002 investigation involving pediatric cochlear implant recipients identified meningitis episodes from January 1, 1997, through September 15, 2002. The incidence of pneumococcal meningitis in the cohort was 138.2 cases per 100000 person-years, >30 times higher than that for children in the general US population. Children with implants with positioners were at higher risk than children with other implant models. This higher risk of bacterial meningitis continued for up to 24 months after implantation.
To evaluate additional reported cases to determine whether the increased rate of bacterial meningitis among children with cochlear implants extended beyond 24 months after implantation.
Our study population consisted of the cohort of children identified through the 2002 investigation; it included 4265 children who received cochlear implants in the United States between January 1, 1997, and August 6, 2002, and who were <6 years of age at the time of implantation. We calculated updated incidence rates and incidence according to time since implantation.
We identified 12 new episodes of meningitis for 12 children. Eleven of the children had implants with positioners; 2 children died. Six episodes occurred >24 months after implantation. When cases identified in the 2002 and 2004 investigations were combined, the incidence rate of > or =24-months postimplantation bacterial meningitis among children with positioners was 450 cases per 100000 person-years, compared with no cases among children without positioners.
Our updated findings support continued monitoring and prompt treatment of bacterial infections by health care providers and parents of children with cochlear implants. This vigilance remains important beyond 2 years after implantation, particularly among children with positioners. The vaccination recommendations for all children with implants, with and without positioners, and all potential recipients of implants continue to apply.

Download full-text

Full-text

Available from: Eric A Mann, Feb 11, 2015
0 Followers
 · 
128 Views
 · 
8 Downloads
  • Source
    • "Recent evidence suggests that children with sensorineural hearing loss with or without cochlear implants are at a higher risk for developing bacterial meningitis than the population in general (Biernath et al. 2006; Parner et al. 2007). It does appear from these data that cochlear implants impart an additional risk for contracting meningitis beyond that of having hearing loss alone. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Cooperation through mutual respect for one another's skills and opinions forms the backbone for successful col-laboration for the child and family's benefit. In an effort to create a timely diagnosis and early in-tervention, we have created a timeline for the events of the first year of life (figure 2). While not set in stone, we believe this serves as a rough guide for the events of the first year of life as it relates to hearing loss and its man-agement. The cornerstone goals of the first year are: (1) identification of hearing loss and establishing precise auditory thresholds; (2) diagnosis of the etiology for the hearing impair-ment; (3) intervention through provision of appropriate treatment and/or technologies; and (4) education by providing information for families to help make decisions.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parents of children with severe to profound hearing loss have to make a number of fundamental decisions for their children. These decisions include communication and amplifi cation options. In particular, the parents must decide whether and when their child will receive cochlear implants, and whether these will be implanted unilaterally or bilaterally. The objective of this study was to describe the decision-making needs of parents making the cochlear implant decision for their children. Semi-structured interviews were conducted with eight parents and eight cochlear implant team members at a Canadian cochlear implant centre to document parental and clinician recollections and opinions of the decision-making process related to a unilateral or bilateral cochlear implantation. The results demonstrated that the decision to go ahead with a cochlear implantation was consistently based on the parents' preferences for spoken communication for their children. Parents reported satisfaction with the cochlear implant decision-making process. Two of eight parents felt that additional information on unilateral cochlear implantation risks and benefi ts should have been provided. Four of eight parents described how more information on the experiences of other families would have been helpful for their decision. Parental and clinical perceptions of the bilateral implantation decision were highly variable. All parents stated that additional information on bilateral cochlear implantation was needed. Based on the results of the interviews, it is concluded that there is a need for information and resources for bilateral cochlear implantation decision-making.
Show more