Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand
Introduction: This study aimed to compare the risks and case fatality rate (CFR) between neonatal multidrug-resistant (MDR) and non-MDR meningitis. Methodology: a secondary analysis of a case-control studies in a Thai neonatal intensive care unit between 1990 and 2018 was performed. The pathogen...
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The Journal of Infection in Developing Countries
2021-07-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/12808 |
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| author | Anucha Thatrimontrichai Waricha Janjindamai Supaporn Dissaneevate Gunlawadee Maneenil |
| author_facet | Anucha Thatrimontrichai Waricha Janjindamai Supaporn Dissaneevate Gunlawadee Maneenil |
| author_sort | Anucha Thatrimontrichai |
| collection | DOAJ |
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Introduction: This study aimed to compare the risks and case fatality rate (CFR) between neonatal multidrug-resistant (MDR) and non-MDR meningitis.
Methodology: a secondary analysis of a case-control studies in a Thai neonatal intensive care unit between 1990 and 2018 was performed. The pathogenic organisms causing neonatal meningitis were Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae, Acinetobacter spp., and Pseudomonas aeruginosa. A MDR organism was defined as an isolate that was non-susceptible to at least 1 agent in at least 3 antimicrobial categories. The multivariate regression was analyzed for MDR and non-MDR samples of neonatal meningitis.
Results: Over a period of 29 years, the number of neonatal MDR and non-MDR meningitis cases were 17 and 21, respectively. The medians (interquartile ranges) of gestational age, birthweight and onset of meningitis were 35 (29.5-38) weeks, 1,945 (1,218-2,859) grams and 6.5 (2.8-17.9) days, respectively. The most common organism was Acinetobacter baumannii (32%). By multivariate analysis, neonates who had MDR meningitis were more likely to have a lower Apgar score at 5 minutes (adjusted odds ratio: 95% confidence intervals = 0.66 [0.44-0.99], p = 0.04). The crude CFR of neonatal meningitis was 32%. Non-survivors in MDR meningitis (58.8%) were significantly higher than non-MDR meningitis (9.5%, p = 0.004). The most common pathogen in non-survivors was carbapenem-resistant Acinetobacter baumannii.
Conclusions: Neonatal MDR meningitis has an association with lower APGAR scores, and higher CFR as well as Acinetobacter baumannii. Multifaceted infection prevention, and control programs for MDR organisms are crucial, and must be strictly implemented in high MDR areas.
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| format | Article |
| id | doaj-art-4141e5cec024434bbb77167b56c97e6f |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-4141e5cec024434bbb77167b56c97e6f2025-08-20T03:48:46ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-07-01150710.3855/jidc.12808Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in ThailandAnucha Thatrimontrichai0Waricha Janjindamai1Supaporn Dissaneevate2Gunlawadee Maneenil3Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandDivision of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Introduction: This study aimed to compare the risks and case fatality rate (CFR) between neonatal multidrug-resistant (MDR) and non-MDR meningitis. Methodology: a secondary analysis of a case-control studies in a Thai neonatal intensive care unit between 1990 and 2018 was performed. The pathogenic organisms causing neonatal meningitis were Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae, Acinetobacter spp., and Pseudomonas aeruginosa. A MDR organism was defined as an isolate that was non-susceptible to at least 1 agent in at least 3 antimicrobial categories. The multivariate regression was analyzed for MDR and non-MDR samples of neonatal meningitis. Results: Over a period of 29 years, the number of neonatal MDR and non-MDR meningitis cases were 17 and 21, respectively. The medians (interquartile ranges) of gestational age, birthweight and onset of meningitis were 35 (29.5-38) weeks, 1,945 (1,218-2,859) grams and 6.5 (2.8-17.9) days, respectively. The most common organism was Acinetobacter baumannii (32%). By multivariate analysis, neonates who had MDR meningitis were more likely to have a lower Apgar score at 5 minutes (adjusted odds ratio: 95% confidence intervals = 0.66 [0.44-0.99], p = 0.04). The crude CFR of neonatal meningitis was 32%. Non-survivors in MDR meningitis (58.8%) were significantly higher than non-MDR meningitis (9.5%, p = 0.004). The most common pathogen in non-survivors was carbapenem-resistant Acinetobacter baumannii. Conclusions: Neonatal MDR meningitis has an association with lower APGAR scores, and higher CFR as well as Acinetobacter baumannii. Multifaceted infection prevention, and control programs for MDR organisms are crucial, and must be strictly implemented in high MDR areas. https://jidc.org/index.php/journal/article/view/12808Acinetobacter baumanniicarbapenemsmeningitisneonatal sepsismulti-drug resistance |
| spellingShingle | Anucha Thatrimontrichai Waricha Janjindamai Supaporn Dissaneevate Gunlawadee Maneenil Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand Journal of Infection in Developing Countries Acinetobacter baumannii carbapenems meningitis neonatal sepsis multi-drug resistance |
| title | Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand |
| title_full | Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand |
| title_fullStr | Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand |
| title_full_unstemmed | Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand |
| title_short | Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand |
| title_sort | neonatal multidrug resistant bacterial meningitis a 29 year study from a tertiary hospital in thailand |
| topic | Acinetobacter baumannii carbapenems meningitis neonatal sepsis multi-drug resistance |
| url | https://jidc.org/index.php/journal/article/view/12808 |
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