Ten-year review of hospital-acquired neonatal meningitis in a tertiary-level NICU: the important role of acinetobacter species

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BACKGROUND: Meningitis during the neonatal period is a potentially devastating condition with high morbidity and mortality. Pathogens cause meningitis varying with gestational age at birth, age at presentation, and geographic location. METHODS: This 10-year retrospective cross-sectional study, conducted from 2014 to 2023, involved thoroughly evaluating patient files who developed hospital-acquired neonatal meningitis during their hospitalization, with the aim of identifying the causative pathogens and predisposing factors to mortality and hydrocephalus. in a large, referral neonatal intensive care unit at Imam Khomeini Hospital in Ahvaz, Iran. RESULTS: The files of 33 infants with meningitis were examined. The number of premature and low birth weight babies was 30(90.9%) and 27(81.8%), respectively. The studied neonates' mean gestational age and birth weight were 32.6 ± 3.3 weeks and 1812 ± 739 g, respectively. Meningitis with late-onset occurred in 28(84.8%) infants and Gram-negative bacteria in 24(72.7%) infants. Out of a total of 33 neonates with meningitis, 13(39.3%) of whom died. The pathogen most frequently isolated from cerebrospinal fluid cultures was Acinetobacter species, found in 16(48.4%) patients. Occurrences of seizures in the first three days of meningitis, meningitis with gram-negative bacteria, and leukocytosis of more than 15,000 at the onset of meningitis increased the probability of death and hydrocephalus in infants. CONCLUSION: Considering that most of the neonates in this study were premature, had low birth weight, and had nosocomial late-onset meningitis with Gram-negative bacteria, it is necessary to prevent them from contracting meningitis with strict and multifaceted care while hospitalized.