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Updated: Apr 16, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Neonatal infections due to multi-resistant strains: Epidemiology, current treatment, emerging therapeutic approaches
Chryssoula Tzialla1, Alessandro Borghesi1, Margherita Pozzi1
1Neonatal Intensive Care Unit, Fondazione IRRCS Policlinico San Matteo, Pavia, Italy.
Insights
Antibiotic resistance in neonatal intensive care units is a growing threat, leading to limited treatment options for severe infections. New strategies are urgently needed to combat multidrug-resistant bacteria in newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Severe neonatal infections cause over a million deaths annually worldwide.
- Widespread antibiotic use drives the emergence of multidrug-resistant (MDR) bacteria.
- Neonatal intensive care units (NICUs) face rising MDR gram-positive and gram-negative infections.
Purpose of the Study:
- To review current knowledge on antibiotic resistance in neonates.
- To discuss therapeutic choices for MDR infections in newborns.
- To highlight prevention strategies against resistant strains in NICUs.
Main Methods:
- Literature review on antibiotic resistance in neonatal populations.
- Analysis of current treatment options for MDR gram-negative and gram-positive infections.
- Synthesis of prevention strategies to mitigate resistance.
Main Results:
- Limited new antibiotic options for MDR gram-negative infections in neonates.
- Treatment challenges are increasing due to rising resistance rates.
- Existing options for MDR gram-positive infections are more numerous but still face challenges.
Conclusions:
- Urgent need for novel therapeutic agents against MDR gram-negative pathogens in neonates.
- Implementation of robust prevention strategies is crucial to curb resistance spread.
- Multifaceted approaches are required to address the growing threat of antibiotic resistance in neonatal care.
Abstract:
Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units. The benefits of antibiotic therapy when indicated are clearly enormous, but the continued and widespread use of antibiotics has generated over the years a strong selective pressure on microorganisms, favoring the emergence of resistant strains. Health agencies worldwide are galvanizing attention toward antibiotic resistance in gram-positive and gram-negative bacteria. Infections in neonatal units due to multidrug and extensively multidrug resistant bacteria are rising and are already seriously challenging antibiotic treatment options. While there is a growing choice of agents against multi-resistant gram-positive bacteria, new options for multi-resistant gram-negative bacteria in the clinical practice have decreased significantly in the last 20 years making the treatment of infections caused by multidrug-resistant pathogens challenging mostly in neonates. Treatment options are currently limited and will be some years before any new treatment for neonates become available for clinical use, if ever. The aim of the review is to highlight the current knowledge on antibiotic resistance in the neonatal population, the possible therapeutic choices, and the prevention strategies to adopt in order to reduce the emergency and spread of resistant strains.
