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Updated: Oct 26, 2025
Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat
Published on: October 29, 2014
Neonatal multidrug-resistant bacterial meningitis: a 29-year study from a tertiary hospital in Thailand
Anucha Thatrimontrichai1, Waricha Janjindamai2, Supaporn Dissaneevate2
1Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. tanucha@medicine.psu.ac.th.
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.
Insights
Neonatal multidrug-resistant (MDR) meningitis is linked to lower Apgar scores and significantly higher mortality rates compared to non-MDR meningitis. Strict infection control is vital, especially with Acinetobacter baumannii.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Neonatal meningitis poses a significant threat to infant health.
- The rise of multidrug-resistant (MDR) organisms complicates treatment and increases mortality.
- Understanding the specific risks associated with MDR meningitis is crucial for effective intervention.
Purpose of the Study:
- To compare the risks and case fatality rate (CFR) of neonatal meningitis caused by multidrug-resistant (MDR) versus non-MDR organisms.
- To identify specific risk factors and outcomes associated with MDR neonatal meningitis.
Main Methods:
- A secondary analysis of a case-control study conducted in a Thai neonatal intensive care unit from 1990 to 2018.
- Defined MDR organisms as non-susceptible to at least 1 agent in at least 3 antimicrobial categories.
- Utilized multivariate regression to analyze data from MDR and non-MDR neonatal meningitis cases.
Main Results:
- Over 29 years, 17 MDR and 21 non-MDR neonatal meningitis cases were identified.
- Neonates with MDR meningitis had lower Apgar scores (aOR=0.66; 95% CI=0.44-0.99).
- The crude CFR was 32%; MDR meningitis had a significantly higher non-survival rate (58.8%) compared to non-MDR (9.5%). Carbapenem-resistant Acinetobacter baumannii was the most common pathogen in non-survivors.
Conclusions:
- Neonatal MDR meningitis is associated with poorer outcomes, including lower Apgar scores and increased mortality.
- Acinetobacter baumannii, particularly carbapenem-resistant strains, is a significant pathogen in fatal MDR meningitis cases.
- Implementing comprehensive infection prevention and control programs for MDR organisms is essential in high-prevalence areas.
