KK Chik, WK To, K Luk, B Lam, CC Shek, C Tse, D Ng

Abstract

Introduction: Neonatal meningitis causes severe morbidity. The incidence of ampicillin-resistant Escherichia coli (E. coli) meningitis was reported to be increasing in overseas neonatal intensive care units (NICUs) recently. This is the first local study to investigate E. coli neonatal meningitis. Choice of empirical antibiotics for intrapartum period and neonates will be discussed. Methods: Retrospective study was performed in 2 NICUs between 1st January 2011 and 31st May 2016. Neonates with E. coli meningitis were included. Demographic data, laboratory results, antibiotics use and antimicrobial susceptibilities were reviewed. Results: Eleven neonates were identified and 55% had early-onset (EO) meningitis. Ninety-one percent of E. coli isolates were ampicillin-resistant. Twenty-seven percent were extended-spectrum-beta-lactamase (ESBL) producing and all were isolated in EO meningitis group. Use of intrapartum ampicillin and ESBL-E. coli infection in neonates showed no statistical significance. Conclusions: The risk of ampicillin-resistant E. coli meningitis in neonates continues despite of using intrapartum antibiotics in high risk group. Choice of intrapartum antibiotic and empirical treatment of neonatal sepsis has an urgent need to be reviewed.