The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed
Abstract Background In 2017, WHO published a list of bacteria for which new antibiotics are urgently needed. The main bacteria are common causes of nosocomial meningitis. The key focuses are carbapenem resistance, vancomycin resistance, methicillin resistance, and extended-spectrum beta-lactamase (E...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-025-10927-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849699211615928320 |
|---|---|
| author | Yi Ye Yuyang Qiu Guiyun Li Yueyue Kong Jiawei Ma Siying Ren Likun Wang Guofeng Wu Guangzhi Shi |
| author_facet | Yi Ye Yuyang Qiu Guiyun Li Yueyue Kong Jiawei Ma Siying Ren Likun Wang Guofeng Wu Guangzhi Shi |
| author_sort | Yi Ye |
| collection | DOAJ |
| description | Abstract Background In 2017, WHO published a list of bacteria for which new antibiotics are urgently needed. The main bacteria are common causes of nosocomial meningitis. The key focuses are carbapenem resistance, vancomycin resistance, methicillin resistance, and extended-spectrum beta-lactamase (ESBL) production. There are a limited number of appropriate drugs to treat nosocomial meningitis due to resistance and permeability of drugs, we aimed to discuss the urgency by analyzing the causes and related outcomes of antimicrobial resistance in the pathogens. Methods We collected 333 patients in whom 854 pathogens were isolated. Poor outcome was defined as a Glasgow Outcome Scale of 1–3. The adjusted analysis of risk factors for poor outcomes was performed using a generalized linear model. Results The main pathogens were Enterobacteriaceae (n = 186, 21.8%), A. baumannii (n = 66, 7.7%), S. aureus (n = 38, 4.4%), E. faecium (n = 27, 3.2%), and P. aeruginosa (n = 16, 1.9%). Vancomycin resistance was found in 0% (0/38) of S. aureus and 22.2% (6/27) of E. faecium. Carbapenem resistance was found in 35.5% (16/186) of Enterobacteriaceae, 80.3% (53/66) of A. baumannii and 37.5% (6/16) of P. aeruginosa. ESBL production occurred in 54.8% (102/186) of Enterobacteriaceae and methicillin resistance occurred in 39.5% (15/38) of S. aureus. Additionally, 136 (40.8%) cases had poor outcomes. Vancomycin or carbapenem resistance (relative risk 1.98, 95% confidence interval [1.72–4.12], p < 0.001) and ESBL production or methicillin resistance (relative risk 1.60, 95% confidence interval [1.10–3.07], p = 0.020) were risk factors for poor outcomes. Conclusion In nosocomial meningitis, drug-resistant A. baumannii and Enterobacteriaceae were predominant, requiring urgent development of new antimicrobials for treatment. Clinical trial Not applicable. |
| format | Article |
| id | doaj-art-9157036ed3694d9cbcdb9e2b25888c88 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-9157036ed3694d9cbcdb9e2b25888c882025-08-20T03:18:41ZengBMCBMC Infectious Diseases1471-23342025-04-012511710.1186/s12879-025-10927-1The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently neededYi Ye0Yuyang Qiu1Guiyun Li2Yueyue Kong3Jiawei Ma4Siying Ren5Likun Wang6Guofeng Wu7Guangzhi Shi8Emergency Department, the Affiliated Hospital of Guizhou Medical University, Guizhou Medical UniversityDepartment of Emergency, Affiliated Jinyang Hospital of Guizhou Medical UniversityDepartment of Emergency, Affiliated Jinyang Hospital of Guizhou Medical UniversityDepartment of Critical Care Medicine, Beijing Jishuitan HospitalDepartment of Emergency, Beijing Ditan HospitalEmergency Department, the Affiliated Hospital of Guizhou Medical University, Guizhou Medical UniversityEmergency Department, the Affiliated Hospital of Guizhou Medical University, Guizhou Medical UniversityEmergency Department, the Affiliated Hospital of Guizhou Medical University, Guizhou Medical UniversityDepartment of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical UniversityAbstract Background In 2017, WHO published a list of bacteria for which new antibiotics are urgently needed. The main bacteria are common causes of nosocomial meningitis. The key focuses are carbapenem resistance, vancomycin resistance, methicillin resistance, and extended-spectrum beta-lactamase (ESBL) production. There are a limited number of appropriate drugs to treat nosocomial meningitis due to resistance and permeability of drugs, we aimed to discuss the urgency by analyzing the causes and related outcomes of antimicrobial resistance in the pathogens. Methods We collected 333 patients in whom 854 pathogens were isolated. Poor outcome was defined as a Glasgow Outcome Scale of 1–3. The adjusted analysis of risk factors for poor outcomes was performed using a generalized linear model. Results The main pathogens were Enterobacteriaceae (n = 186, 21.8%), A. baumannii (n = 66, 7.7%), S. aureus (n = 38, 4.4%), E. faecium (n = 27, 3.2%), and P. aeruginosa (n = 16, 1.9%). Vancomycin resistance was found in 0% (0/38) of S. aureus and 22.2% (6/27) of E. faecium. Carbapenem resistance was found in 35.5% (16/186) of Enterobacteriaceae, 80.3% (53/66) of A. baumannii and 37.5% (6/16) of P. aeruginosa. ESBL production occurred in 54.8% (102/186) of Enterobacteriaceae and methicillin resistance occurred in 39.5% (15/38) of S. aureus. Additionally, 136 (40.8%) cases had poor outcomes. Vancomycin or carbapenem resistance (relative risk 1.98, 95% confidence interval [1.72–4.12], p < 0.001) and ESBL production or methicillin resistance (relative risk 1.60, 95% confidence interval [1.10–3.07], p = 0.020) were risk factors for poor outcomes. Conclusion In nosocomial meningitis, drug-resistant A. baumannii and Enterobacteriaceae were predominant, requiring urgent development of new antimicrobials for treatment. Clinical trial Not applicable.https://doi.org/10.1186/s12879-025-10927-1Nosocomial meningitisAcinetobacter baumanniiEnterobacteriaceaeCarbapenem resistanceESBL production |
| spellingShingle | Yi Ye Yuyang Qiu Guiyun Li Yueyue Kong Jiawei Ma Siying Ren Likun Wang Guofeng Wu Guangzhi Shi The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed BMC Infectious Diseases Nosocomial meningitis Acinetobacter baumannii Enterobacteriaceae Carbapenem resistance ESBL production |
| title | The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| title_full | The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| title_fullStr | The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| title_full_unstemmed | The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| title_short | The causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| title_sort | causes and outcomes of nosocomial meningitis by pathogens for which new antibiotics are urgently needed |
| topic | Nosocomial meningitis Acinetobacter baumannii Enterobacteriaceae Carbapenem resistance ESBL production |
| url | https://doi.org/10.1186/s12879-025-10927-1 |
| work_keys_str_mv | AT yiye thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT yuyangqiu thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guiyunli thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT yueyuekong thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT jiaweima thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT siyingren thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT likunwang thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guofengwu thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guangzhishi thecausesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT yiye causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT yuyangqiu causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guiyunli causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT yueyuekong causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT jiaweima causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT siyingren causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT likunwang causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guofengwu causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded AT guangzhishi causesandoutcomesofnosocomialmeningitisbypathogensforwhichnewantibioticsareurgentlyneeded |