Challenges in the management of multidrug-resistant Gram-negative bacterial meningitis in children: a decade of clinical insights

Managing GNB meningitis is challenging due to poor CSF penetration of many antibiotics and rising multidrug resistance. Given the evolving resistance patterns, particularly the persistence of penicillin resistance and the emergence of carbapenem resistance, continuous surveillance of antimicrobial susceptibility profiles is essential. This allows for timely adaptation of empiric therapy protocols and supports effective infection control strategies. Although surgical procedures and catheter use were not significantly associated with mortality in our cohort, these remain key risk factors for the development of Gram-negative meningitis and ventriculitis. Therefore, strict adherence to aseptic technique is essential for prevention.