The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis
<b>Background</b>: We aimed to describe the clinical features of Gram-negative bacillary (GNB) meningitis in neonates and investigate the risk factors associated with final adverse outcomes of neonatal GNB meningitis. <b>Methods</b>: From 2003 to 2020, all neonates (aged ≤ 90...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/7/1131 |
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| author | Mei-Chen Ou-Yang Ming-Horng Tsai Shih-Ming Chu Chih-Chen Chen Peng-Hong Yang Hsuan-Rong Huang Ching-Min Chang Ren-Huei Fu Jen-Fu Hsu |
| author_facet | Mei-Chen Ou-Yang Ming-Horng Tsai Shih-Ming Chu Chih-Chen Chen Peng-Hong Yang Hsuan-Rong Huang Ching-Min Chang Ren-Huei Fu Jen-Fu Hsu |
| author_sort | Mei-Chen Ou-Yang |
| collection | DOAJ |
| description | <b>Background</b>: We aimed to describe the clinical features of Gram-negative bacillary (GNB) meningitis in neonates and investigate the risk factors associated with final adverse outcomes of neonatal GNB meningitis. <b>Methods</b>: From 2003 to 2020, all neonates (aged ≤ 90 days old) with bacterial meningitis who were hospitalized in four tertiary-level neonatal intensive care units (NICUs) of two medical centers in Taiwan were enrolled. Neonates with GNB meningitis were compared with those with Streptococcus agalactiae (group B streptococcus, GBS) meningitis. <b>Results</b>: During the study period, a total of 153 neonates with bacterial meningitis were identified and enrolled. GNB and GBS accounted for 40.5% (<i>n</i> = 62) and 35.3% (<i>n</i> = 54) of all neonatal bacterial meningitis, respectively. In neonates with GNB meningitis, the final mortality rate was 6.5% (4 neonates died); 48 (77.4%) had neurological complications, and 26 (44.8%) of 58 survivors had neurological sequelae at discharge. Although the final outcomes were comparable between neonates with GNB meningitis and those with GBS meningitis, neonates with GNB meningitis were more likely to have more severe clinical manifestations initially and have ventriculomegaly at follow-up. After multivariate logistic regression analysis, neonates with seizure at onset, early onset sepsis, and requirement of surgical intervention for neurological complications were independently associated with final adverse outcomes. <b>Conclusions</b>: GNB meningitis was associated with a high risk of neurological complications and sequelae, although it did not significantly increase the final mortality rate. Close monitoring of the occurrence of neurological complications and advanced therapeutic strategies to optimize the outcomes are urgently needed in the future. |
| first_indexed | 2024-03-11T01:22:59Z |
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| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T01:22:59Z |
| publishDate | 2023-06-01 |
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| series | Antibiotics |
| spelling | doaj.art-e066ddd1b5b649c786171a7a75abdb8f2023-11-18T18:02:39ZengMDPI AGAntibiotics2079-63822023-06-01127113110.3390/antibiotics12071131The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary MeningitisMei-Chen Ou-Yang0Ming-Horng Tsai1Shih-Ming Chu2Chih-Chen Chen3Peng-Hong Yang4Hsuan-Rong Huang5Ching-Min Chang6Ren-Huei Fu7Jen-Fu Hsu8Division of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 33302, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 33302, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanCollege of Medicine, Chang Gung University, Taoyuan 33302, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan<b>Background</b>: We aimed to describe the clinical features of Gram-negative bacillary (GNB) meningitis in neonates and investigate the risk factors associated with final adverse outcomes of neonatal GNB meningitis. <b>Methods</b>: From 2003 to 2020, all neonates (aged ≤ 90 days old) with bacterial meningitis who were hospitalized in four tertiary-level neonatal intensive care units (NICUs) of two medical centers in Taiwan were enrolled. Neonates with GNB meningitis were compared with those with Streptococcus agalactiae (group B streptococcus, GBS) meningitis. <b>Results</b>: During the study period, a total of 153 neonates with bacterial meningitis were identified and enrolled. GNB and GBS accounted for 40.5% (<i>n</i> = 62) and 35.3% (<i>n</i> = 54) of all neonatal bacterial meningitis, respectively. In neonates with GNB meningitis, the final mortality rate was 6.5% (4 neonates died); 48 (77.4%) had neurological complications, and 26 (44.8%) of 58 survivors had neurological sequelae at discharge. Although the final outcomes were comparable between neonates with GNB meningitis and those with GBS meningitis, neonates with GNB meningitis were more likely to have more severe clinical manifestations initially and have ventriculomegaly at follow-up. After multivariate logistic regression analysis, neonates with seizure at onset, early onset sepsis, and requirement of surgical intervention for neurological complications were independently associated with final adverse outcomes. <b>Conclusions</b>: GNB meningitis was associated with a high risk of neurological complications and sequelae, although it did not significantly increase the final mortality rate. Close monitoring of the occurrence of neurological complications and advanced therapeutic strategies to optimize the outcomes are urgently needed in the future.https://www.mdpi.com/2079-6382/12/7/1131Gram-negative bacillibacterial meningitisneurological sequelaelate-onset sepsis<i>E. coli</i> |
| spellingShingle | Mei-Chen Ou-Yang Ming-Horng Tsai Shih-Ming Chu Chih-Chen Chen Peng-Hong Yang Hsuan-Rong Huang Ching-Min Chang Ren-Huei Fu Jen-Fu Hsu The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis Antibiotics Gram-negative bacilli bacterial meningitis neurological sequelae late-onset sepsis <i>E. coli</i> |
| title | The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis |
| title_full | The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis |
| title_fullStr | The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis |
| title_full_unstemmed | The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis |
| title_short | The Clinical Characteristics, Microbiology and Risk Factors for Adverse Outcomes in Neonates with Gram-Negative Bacillary Meningitis |
| title_sort | clinical characteristics microbiology and risk factors for adverse outcomes in neonates with gram negative bacillary meningitis |
| topic | Gram-negative bacilli bacterial meningitis neurological sequelae late-onset sepsis <i>E. coli</i> |
| url | https://www.mdpi.com/2079-6382/12/7/1131 |
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