Related Experiment Video
Updated: Feb 28, 2026
08:46
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
7.0K
Risk Factors and Outcomes of Extensively Drug-Resistant Gram-Negative Bacilli in Neonates with Late-Onset Sepsis
Sanchat Sanchainara1, Anucha Thatrimontrichai1, Praew Chareesri1
1Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Antibiotics (Basel, Switzerland)
|February 27, 2026
Summary
Extensively drug-resistant Gram-negative bacilli (XDR-GNB) infections in neonates are linked to gastrointestinal issues and umbilical catheter use. Early empirical colistin is recommended for neonates with septic shock in high-XDR settings.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Extensively drug-resistant Gram-negative bacilli (XDR-GNB) pose a significant threat to vulnerable neonates.
- Understanding the specific risks and outcomes associated with XDR-GNB in this population is crucial for effective management.
Purpose of the Study:
- To identify risk factors and clinical outcomes of XDR-GNB bacteremia in neonates.
- To compare characteristics and outcomes of neonates with and without XDR-GNB sepsis.
Main Methods:
- Retrospective case-control study (1995-2024) involving neonates with late-onset sepsis.
- Comparison of neonates with XDR-GNB bacteremia (n=26) against those without (n=106).
- Multivariable analysis using Firth's penalized likelihood method to identify independent risk factors.
Main Results:
- Prevalence of XDR-GNB was 19.7%; common pathogens included Acinetobacter baumannii and Klebsiella pneumoniae.
- XDR-GNB group had earlier sepsis onset, higher rates of gastrointestinal anomalies (aOR 3.81), and umbilical arterial catheterization (aOR 3.04).
- Higher incidence of septic shock (50.0%) and inadequate empiric antimicrobial therapy (34.6%) in the XDR-GNB group.
Conclusions:
- Empirical colistin therapy is advised for neonates with septic shock and risk factors (GI anomalies, umbilical catheter) in high-XDR environments.
- Multimodal interventions, including antimicrobial stewardship, are essential for preventing neonatal XDR-GNB sepsis.
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