Emerging Antibiotic Resistance Pattern in a Neonatal Intensive Care Unit in Pokhara, Nepal

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Neonatal Care

Background:

• Neonatal sepsis poses a significant challenge in Nepal due to escalating antimicrobial resistance.
• Understanding local resistance patterns is crucial for effective treatment strategies.

Purpose of the Study:

• To determine the antibiotic resistance patterns of culture-proven infections in neonates admitted to a neonatal intensive care unit (NICU).

Main Methods:

• A prospective observational study conducted in the NICU of Pokhara Academy of Health Sciences over one year.
• Collected demographic, clinical, and microbiological data from neonates with positive cultures (blood, CSF, endotracheal tube, pus).
• Analyzed antimicrobial susceptibility testing (AST) results for all identified isolates.

Main Results:

• Out of 1327 neonates, 51 (3.8%) had culture-positive infections.
• Gram-negative bacteria (68.6%) predominated, including Pseudomonas (23.5%) and Acinetobacter (17.6%).
• High resistance rates were observed: Third-generation cephalosporins (75%), aminoglycosides (87%), fluoroquinolones (61%), penicillin (59.3%), and 100% resistance to carbapenems among Gram-negative isolates.

Conclusions:

• Significant antimicrobial resistance exists among Gram-negative pathogens in neonatal sepsis in Nepal, even against reserved antibiotics.
• Urgent need for rational antibiotic prescribing and antimicrobial stewardship programs in NICUs.