frequency, bacteriological profile, and outcome of neonatal sepsis with carbapenem-resistant gram-negative bacteria at the tertiary neonatal intensive care unit, ahvaz, iran

Background: one of the leading causes of neonatal mortality in low- and middle-income countries (lmics) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. objectives: this study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant gram-negative neonatal sepsis in southwest iran. methods: this 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. the study included all neonates hospitalized from birth who had positive blood cultures for gram-negative bacteria. patients were divided into carbapenem-resistant and carbapenem-sensitive groups. results: during the study, gram-negative bacteria were isolated from the blood cultures of 113 neonates. positive gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. in these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. the study found 45 (39.8%) infants with early-onset sepsis. acinetobacterwas the most common isolated organism, while enterobacterhad the lowest isolation rate. carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. acinetobacterhad the highest prevalence of carbapenem resistance, while pseudomonashad the lowest. mortality rates in infants infected with carbapenem resistance bacteria (crb) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (csb). conclusions: the frequency of carbapenem-resistant gram-negative sepsis in our ward was 1.52 percent of all admissions, and acinetobacterbacteria was the most common cause of this type of neonatal sepsis. infants infected with crb had a higher mortality rate than those infected with csb, 89.3% versus 10.7%.