Conclusion:Neonates developed CRE much earlier than previously reported. Invasive procedures on admission carry an associated higher risk for developing CRE, more than the length of stay as previously stipulated. Prevalence of CRE seems to be high in middle-income countries with higher mortality. Thus, strict infection prevention and control (IPC) measures during admission and during the first weeks of life can decrease the incidence and outcome of CRE-related mortality and morbidity.

Acinetobacter baumannii causes invasive paediatric infections, including bacteraemia and meningitis, but neonatal meningitis and ventriculitis is uncommon. The treatment of multidrug resistant (MDR) Acinetobacter infections often relies on colistin, a polymyxin antibiotic, as a last resort. Increased use of this drug has led to the emergence of colistin resistance. An unusual case of colistin-resistant Acinetobacter baumannii ventriculitis in a premature neonate managed with intraventricular colistin is described.