January 2017 17- 9
Surveillance Definitions
Reporting instructions
- Report as MEN if meningitis (MEN) and encephalitis (IC) are present together.
- Report as IC if meningitis (MEN) and a brain abscess (IC) are present together after operation.
- Report as SA if meningitis (MEN) and spinal abscess (SA) are present together.
MEN-Meningitis or ventriculitis
- Meningitis or ventriculitis must meet at least one of the following criteria:
- 1.Patient has organism(s) identified from cerebrospinal fluid (CSF) by a culture or non-culture basedmicrobiologic testing method which is performed for purposes of clinical diagnosis or treatment(e.g., not Active Surveillance Culture/Testing (ASC/AST).
- 2.Patient has at least two of the following:
- i.fever (>38.0°C) or headache (Note: Elements of “i” alone may not be used to meet the tworequired elements)
- ii.meningeal sign(s)*
- iii.cranial nerve sign(s)*
- And at least one of the following:
- a.increased white cells, elevated protein, and decreased glucose in CSF (per reporting laboratory’s reference range)
- b.organism(s) seen on Gram stain of CSF
- c.organism(s) identified from blood by a culture or non-culture based microbiologic testingmethod which is performed for purposes of clinical diagnosis or treatment (e.g., not Active Surveillance Culture/Testing (ASC/AST)
- d.diagnostic single antibody titer (IgM) or 4-fold increase in paired sera (IgG) for organism
3.Patient ≤1 year of age has at least two of the following elements:
i.fever (>38.0°C), hypothermia (<36.0°C±), apnea*, bradycardia*, or irritability* (Note:Elements of “i” alone may not be used to meet the required two elements).
ii.meningeal signs*
iii.cranial nerve signs*
And at least one of the following:
a.increased white cells, elevated protein, and decreased glucose in CSF (per reportinglaboratory’s reference range)
b.organism(s) seen on Gram stain of CSF
c.organism(s) identified from blood by a culture or non-culture based microbiologic testingmethod which is performed for purposes of clinical diagnosis or treatment (e.g., not ActiveSurveillance Culture/Testing (ASC/AST)
d.diagnostic single antibody titer (IgM) or 4-fold increase in paired sera (IgG) for organism
*With no other recognized cause
Reporting instructions
Report meningitis in the newborn as healthcare associated unless there is compellingevidence indicating the meningitis was acquired transplacentally (i.e., unless it wasapparent on the day of birth or the next day).
Report CSF shunt infection as SSI-MEN if it occurs within 90 days of placement; if later orafter manipulation/access, it is considered CNS-MEN but is not reportable as an SSI
REFERENCE: email communications with LHH epidemiology department
Peripheral Brain 