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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
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Antimicrobial-resistant Gram-negative infections in neonates: burden of disease and challenges in treatment

Laura Folgori1, Julia Bielicki, Paul T Heath

  • 1aPaediatric Infectious Disease Research Group, Institute for Infection and Immunity, St George's University of London, London, UK bPaediatric Pharmacology, University Children's Hospital Basel, Basel, Switzerland.

Current Opinion in Infectious Diseases
|March 18, 2017
PubMed
Abstract

Insights

Antimicrobial resistance (AMR) in newborns is a growing global threat, particularly from multidrug-resistant (MDR) Gram-negative bacteria. Limited treatment options and unknown optimal therapies necessitate improved surveillance and clinical trials for MDR neonatal sepsis.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Antimicrobial resistance (AMR) poses significant challenges in neonatal care.
  • Multidrug-resistant (MDR) Gram-negative pathogens are a major concern in neonatal intensive care units (NICUs).

Purpose of the Study:

  • To review the primary challenges of AMR in neonates.
  • To focus on multidrug-resistant Gram-negative pathogens affecting newborns.

Main Methods:

  • Literature review of antimicrobial resistance in neonatal populations.
  • Analysis of global hospital data, particularly from low/middle-income countries.
  • Examination of treatment options for MDR Gram-negative neonatal infections.

Main Results:

  • MDR Gram-negative bacteria are increasingly prevalent in neonates worldwide, with limited therapeutic choices.
  • Extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) cause NICU outbreaks.
  • Many neonatal isolates are resistant to WHO-recommended treatments; older antibiotics like colistin are considered despite limited data.

Conclusions:

  • Enhanced global AMR surveillance in neonates is crucial for understanding the burden and guiding interventions.
  • Optimal empiric treatment for neonatal sepsis in high AMR settings remains undetermined.
  • Clinical trials for older and new antibiotics are essential to improve outcomes for neonatal sepsis caused by MDR Gram-negative bacteria.

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