You are here:

Antimicrobial resistance in neonates with suspected sepsis

Published on


To ensure that scientific research of immediate concern is shared as rapidly as possible, we fast-track accepted articles from the IJTLD and PHA and publish them as edited preprints prior to publication in an issue.

All content in PHA is Open Access and free to read. PHA covers all areas of operational research including: infection control, nutrition, TB, HIV,  vaccines, smoking, COVID-19, microbial resistance or disease outbreaks. Find out more about PHA or sign-up to receive the Table of Contents

Read the PDF for the full text, including the Figures, Tables and References

S. K. Yadav, S. K. Agrawal, S. K. Singh, A. Giri, G. K. Singh, R. Ghimire, A. G. Stewart, K. L. Show, F. L. Moses


SETTING: Nobel Medical College and Teaching Hospital, Biratnagar, Nepal.

OBJECTIVE: To determine the pattern of antimicrobial resistance and hospital exit outcomes in neonates with suspected sepsis in a tertiary neonatal intensive care unit (NICU).

DESIGNThis hospital-based cohort study was conducted to follow patients from January to December 2019. All identified cases of suspected sepsis were enlisted from hospital records.

RESULTS: Sepsis was suspected in 177 (88%) of the 200 cases admitted in the NICU; 52 (29%) were culture-positive. Pseudomonas was the predominant organism isolated (n = 40; 78%), followed by coagulase negative staphylococcus (n = 12, 23%). Nine (17%) of the 52 isolates were resistant to the Access and Watch group of antibiotics, including some resistance to Reserve group drugs such as imipenem and linezolid. Most treated cases (n = 170, 96%) improved, although 7 (4%) left against medical advice.

CONCLUSION: Most of the pathogens were resistant to WHO Access and Watch antibiotics and occasional resistance was observed to Reserve group drugs. Most sepsis was caused by Gram-negative bacilli. Improving turnaround times for antibiotic sensitivity testing using point-of-care testing, and a greater yield of culture-positive results are needed to enhance the management of neonatal sepsis.