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    Epidemiology and Outcomes of Neonatal Meningitis Results of the Turkish Neo-Meningitis Nationwide Study
    (Lippincott Williams and Wilkins, 2024) Oncel M.Y.; Cizmeci M.N.; Karadag-Oncel E.; Elvan-Tuz A.; Canpolat F.E.; Akin M.A.; Uslu S.
    Objective: To investigate the incidence and etiology of neonatal meningitis and to assess the associated risk factors, complications and outcomes in a nationwide multicenter retrospective descriptive study. Method: Twenty-seven centers from 7 geographical regions participated in the study. Newborns with a positive cerebrospinal fluid culture and/or cerebrospinal fluid polymerase chain reaction were included in the study. Demographic characteristics, clinical, laboratory and neuroimaging findings and mortality characteristics were analyzed. Results: A total of 634 confirmed cases of neonatal meningitis were included in the final analysis. The incidence was 2.51 per 1000 intensive care unit hospitalizations and mortality was observed in 149 (23.5%). Gram-positive bacteria were the predominant pathogens (54.5%), with coagulase-negative Staphylococci accounting for 45.3% of the cases, followed by Gram-negative organisms (37.3%). Viral and fungal organisms were isolated in 3.2% and 1.7% of the infants, respectively. Gram-negative culture growth was more common in infants who died (51% vs. 34.6%; P < 0.001). In the multivariable model, the odds of mortality was higher in those with respiratory distress requiring invasive ventilatory support [odds ratio (OR): 10.3; 95% confidence interval (CI): 4.9–21.7; P < 0.01], hypotension requiring inotropes (OR: 4.4; 95% CI: 2.7–7.1; P < 0.001), low birth weight status (OR: 2.5; 95% CI: 1.4–4.6; P = 0.002), lack of exposure to antenatal steroids (OR: 2.4; 95% CI: 1.3–4.4; P = 0.005) and the presence of concomitant sepsis (OR: 1.9; 95% CI: 1.1–3.2; P = 0.017). Conclusions: In this nationwide study, neonatal meningitis was found to be associated with high mortality. Coagulase-negative Staphylococci was the most common causative microorganism followed by Gram-negative bacteria. Severe clinical presentation with invasive mechanical ventilation and inotrope requirement, as well as concomitant sepsis, low birth weight status and lack of exposure to antenatal steroids, were found to be independent risk factors for mortality. © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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    Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: A prospective multicenter study
    (Taylor and Francis Ltd, 2016) Alan S.; Erdeve O.; Cakir U.; Akduman H.; Zenciroglu A.; Akcakus M.; Tunc T.; Gokmen Z.; Ates C.; Atasay B.; Arsan S.; Anik A.; Turkmen M.K.; Erdogan Y.; Oygur N.; Kahvecioglu D.; Yildiz D.; Caner I.; Tekgunduz K.S.; Kurt A.; Yigit Y.; Bilgili G.; Bolat F.; Cevit O.; Ozlu F.; Satar M.; Ertugrul S.; Cakir B.; Unal S.; Iscan B.; Duman N.; Ergor S.N.; Yalaz M.; Celik I.; Celik U.; Hirfanoglu I.M.; Koc E.; Sivasli E.; Melekoglu N.A.; Kiray Bas E.; Bozkaya D.; Korkmaz A.; Ozdemir R.; Karadag A.; Ozer E.; Ilhan O.; Mutlu M.; Aslan Y.; Erener- Ercan T.; Cetinkaya M.; Sahin O.; Akin M.A.; Okumus N.; Demirel G.; Kilic A.; Turkoglu-Unal E.; Bulbul A.; Takci S.; Anuk-Ince D.; Ciftdemir N.A.; Acunas B.; Ozkan H.; Koksal N.; Okulu E.; Demir N.; Tuncer O.; Dizdar E.A.; Oguz S.; Dilmen U.
    Aim: To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs).Methods: A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions.Findings: The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU.Conclusion: RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU. © 2015 Taylor & Francis.