Abstract
This study aimed to determine antimicrobial resistance pattern and predictors of adverse
outcome in neonatal meningitis. A retrospective study by analyzing case files of 134
cases of neonatal meningitis. We noted an alarming degree of multidrug resistance
(MDR) among both gram-negative (Klebsiella
spp ., 50%; Escherichia coli , 100%; and and Acinetobacter
spp ., 50%), as well as positive (Enterococcus , 100%) isolates in cerebrospinal fluid (CSF) culture. The incidence rate of adverse
outcome (i.e., mortality and abnormal neurological examination at discharge) was 8.2
and 17.2%, respectively. On univariate analysis, delayed seeking of medical care,
bulging anterior fontanelle, vomiting, positive sepsis screen, shock during hospital
course, ventriculitis, diversion procedures for raised intracranial pressure, central
line placement, low CSF sugar, and failed hearing screening test at discharge were
associated with increased risk of adverse outcome. Further, delayed seeking of medical
care, shock during hospital course, positive sepsis screen, thrombocytopenia, and
MDR infections were independently found to be associated with adverse outcomes. An
alarming degree of antimicrobial resistance among the CSF isolates necessitates the
need to understand the pathogenesis of resistance and curtail the irrational prescription
of antibiotics in neonatal meningitis. Further, delayed seeking of medical care, shock
during hospital course, positive sepsis screen, thrombocytopenia, and MRD infection
may have prognostic value in neonatal meningitis
Keywords antimicrobial resistance - neonatal meningitis - hearing screening - shock
