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Updated: Sep 20, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Emerging Trend of Multidrug-resistant Organisms Causing Sepsis in Ventilated Newborns
Sudesh Kumar1, Prajna Ray, Ranita Sahana
1Department of Paediatrics, MGM Medical College, Kishanganj, Bihar, India.
Insights
Multidrug-resistant organisms are a significant threat in neonatal intensive care units. This study found a high prevalence of these resistant bacteria, particularly Gram-negative strains, in ventilated newborns with sepsis.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Microbiology
Background:
- Antibiotic and multidrug resistance (MDR) pose significant public health risks.
- MDR organisms are a major concern in intensive care units (ICUs).
- Ventilated newborns in the NICU are particularly vulnerable to infections.
Purpose of the Study:
- To identify and determine the prevalence of MDR organisms in sepsis-positive ventilated newborns.
- To evaluate the antibiotic resistance patterns of these isolated MDR organisms.
- To assess the impact of MDR on neonatal sepsis outcomes.
Main Methods:
- An observational cross-sectional study was conducted in a neonatal ICU.
- 168 neonates were enrolled, with data collected on culture positivity and organism identification.
- Antibiotic resistance patterns were analyzed for isolated MDR strains.
Main Results:
- Culture positivity was observed in 79 (47.02%) of 168 ventilated neonates.
- 53 (67.08%) of isolated organisms were MDR, with Gram-negative strains being more prevalent (56.6%).
- Pseudomonas aeruginosa and coagulase-negative staphylococci (CONS) were the most common MDR organisms. High resistance rates were noted against common antibiotics.
Conclusions:
- There is an alarmingly high prevalence of MDR organisms, especially Gram-negative strains, in EONS.
- The presence of MDR limits initial antibiotic choices, potentially increasing mortality and morbidity.
- Effective strategies are needed to combat the spread of resistant organisms in neonatal ICUs.
Introduction:
Increasing trend of antibiotic and multidrug resistance (MDR) organism are significant public health risks and major issues in intensive care unit (ICU). We aimed to identify, determine the prevalence, and to evaluate their antibiotic resistance pattern in sepsis-positive ventilated newborns.
Materials And Methods:
The observational cross-sectional study was conducted in a neonatal ICU. One hundred and sixty-eight neonates were included.
Results:
One hundred and sixty-eight ventilated newborns were enrolled, of which 79 (47.02%) cases were culture positive. Of the isolated organisms, 53 (67.08%) were MDR, in which 32 (60.03%) with early-onset neonatal sepsis (EONS) and 21 (39.6%) with late-onset neonatal sepsis. Twenty-three (43.39%) isolated organisms were Gram-positive MDR and 30 (56.6%) were Gram-negative MDR. The most common isolated MDR organisms were Pseudomonas aeruginosa and coagulase-negative staphylococci (CONS). The culture positivity of the MDR organism was significantly higher to non-MDR ( P < 0.000017). Among gram negative MDR organism Pseudomonas and Klebsiella was highly resistant against ciprofloxacin and piperacillin with tazobactam respectively. Among MDR Gram-positive bacteria CONS and Enterococcus faecalis was most common. CONS were highly resistant to clindamycin, penicillin, and ciprofloxacin.
Conclusions:
This study showed an alarmingly high prevalence of MDR organisms and Gram-negative strains which were more isolated from EONS. This can limit the initial therapeutic choice regarding antibiotics, leading to increased mortality, morbidity with risk of spreading resistant organisms.
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