Emerging Multidrug-Resistant Bacteria in Indonesian Neonatal Patients: Prevalence and Antimicrobial Resistance...

Neonatal sepsis poses a serious health challenge, especially with the increasing prevalence of multidrug-resistant (MDR) bacteria among Indonesian neonates. This study examines the occurrence of MDR bacteria in clinical samples from neonates and analyzes their resistance patterns to enhance treatment strategies.

From January 2022 to December 2024, a total of 223 bacterial isolates were gathered from neonatal patients with infections at Kanjeng Raden Mas Tumenggung Wongsonegoro Hospital in Semarang, Indonesia. The identification process commenced with Gram staining and assessment of colony morphology preceded by antibiotic susceptibility testing utilizing the VITEK2 Compact systems.

The study findings revealed a notable prevalence of MDR infections. Fecal samples accounted for 29.15% of the samples analyzed, with 63.1% exhibiting MDR characteristics. Blood samples, representing 24.66% of the samples, displayed a concerning MDR rate of 83.6%. Similarly, urine samples (24.66%) showed a MDR rate of 50.9%, while sputum samples (10.76%) presented a striking MDR classification of 91.7%. Key MDR rates were identified in Escherichia coli (45.6%), Staphylococcus spp. (70.4%), Klebsiella pneumoniae (71.9%), Acinetobacter spp. (63.6%), and Pseudomonas aeruginosa (100%). The overall prevalence of MDR infections was calculated at 66.40%, with significant resistance observed towards ampicillin (over 80%) in gram-negative bacteria and benzylpenicillin (over 90%) in gram-positive bacteria, particularly Staphylococcus spp.

The findings underscore the urgent need for effective strategies to combat MDR infections in healthcare settings, emphasizing enhanced antibiotic management, tailored treatment protocols, and a more holistic and systematically structured research strategy for neonatal units in Indonesia.