Multidrug-resistant sepsis in special newborn care units in five district hospitals in India: a prospective cohort study

This study evaluated the incidence of sepsis, pathogen profile, and antimicrobial resistance among neonates admitted to special newborn care units in district hospitals in India. The study enrolled 6612 neonates, with 3357 meeting clinical sepsis criteria. The overall incidence of culture-positive sepsis was 213 (3.2%), with higher rates in outborn neonates. Gram-negative bacilli accounted for 156 (70%) of 223 organisms isolated, with 75%-88% of isolates being multidrug resistant. The study highlights the need for stronger infection prevention and control practices, establishment of blood culture facilities, and implementation of antimicrobial stewardship programs in district-level hospitals in India.