Pattern and trend of bacterial resistance in neonatal sepsis in infants admitted to the neonatal intensive care unit, from 2016 to 2021

  • Amir Naddaf Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Ansari Nasab Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Mamak Shariat Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Parvaneh Sadeghi-Moghaddam Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Samaneh Salarvand Department of Anatomical and Clinical Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  • Zahra Omidi Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Neda Sadat Kosari Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Leyla Sahebi Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Sepsis; Neonatal; Drug resistance; Bacterial; Intensive care units; Neonatal; Klebsiella pneumonia; Staphylococ- cus; Coagulase-negative; Microbial sensitivity tests; Blood culture

Abstract

Background and Objectives: Neonatal septicemia is a significant cause of morbidity and mortality in neonatal intensive care units (NICUs). Understanding the patterns of antibiotic resistance and pathogen prevalence is crucial for effective treat- ment.

Materials and Methods: This cross-sectional study was conducted from 2016 to 2022 in the NICU of Vali-Asr Hospital in Tehran. All neonates diagnosed with septicemia were included. Data were collected using the hospital's registry system. Results: A total of 477 infants were hospitalized with sepsis, with 71.7% classified as early-onset sepsis (EOS) and 28.3% as late-onset sepsis (LOS). The most common pathogens were coagulase-negative Staphylococcus (22.1%), Klebsiella pneu- moniae (14.9%), and Staphylococcus epidermidis (14.3%). The highest antibiotic resistance was observed for erythromy- cin (89.8%), clindamycin (80.6%), gentamicin (66.1%), and ciprofloxacin (63.5%), while vancomycin showed the lowest resistance (11.2%). Significant associations were found between antibiotic resistance with low birth weight and chest tube intervention. Trends in antibiotic resistance varied over the study period, with a notable decrease in resistance in 2021.

Conclusion: The study highlights the high prevalence of antibiotic resistance in neonatal sepsis, emphasizing the need for continuous monitoring and tailored antibiotic stewardship programs. The findings underscore the importance of individual- ized treatment approaches to improve outcomes for neonates with sepsis.

Published
2025-07-26
Section
Articles