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July 11, 1977

Bacterial Meningitis of the Newborn

JAMA. 1977;238(2):127. doi:10.1001/jama.1977.03280020031009

To the Editor.—  The following comments are in response to the article by Jones et al (236:2652).Bacterial meningitis in the newborn is rare and usually caused by Gram-negative organisms. A series of recent reports has demonstrated the isolation and recognition of Grampositive organisms in both mother and child. These include group B streptococci, Listeria monocytogenes, and pneumococci. In our initial report of a case of fatal pneumococcal meningitis and endophthalmitis in a newborn whose mother was also infected,1 we urged a greater interest in "minor" genital infections. Since then little progress has been made in our understanding of the incidence and prevalence of this problem, despite isolated case reports. Keys et al2 demonstrated hematogenous spread of meningococcal organisms from the endocervical regions, and thus it must be assumed that transplacental transmission occurs primarily by this route and probably also by contiguous spread.The report by Jones and