{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:25:15Z","timestamp":1785522315274,"version":"3.56.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T00:00:00Z","timestamp":1749254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Data about epidemiologic and microbiologic patterns of neonatal sepsis in specific regions of low- and middle-income countries can help improve management and stimulate prevention efforts. We conducted a multicentre study within a large metropolitan region in South India to describe the burden of neonatal sepsis; and identify the antimicrobial sensitivity patterns of causative organisms. In a collaborative network of six neonatal intensive care units, standardized data were collected on every admitted neonate with a positive blood culture from June 2020 to May 2022. The frequency of sepsis, the organisms, antimicrobial resistance patterns, and mortality were analysed. Factors associated with lack of \u2018on-target\u2019 initial empirical antibiotic therapy were identified through univariate and multivariate analysis. Among 6229 admissions, the incidence of sepsis was 3.5%. Klebsiella (30%), Coagulase-negative staphylococcus (13%), and Escherichia coli (10%) were the commonest organisms. The overall incidence of multidrug resistance among Gram-negative organisms was 26%, with organism-specific incidence as follows: Klebsiella (48%), Acinetobacter (81%), and E. coli (45%). The organisms were sensitive to one or more of the initial empirical antibiotics used (\u2018on-target\u2019) in 48% [95% confidence interval (CI) 45\u201358%] of cases. Mortality was higher in those neonates where initial antibiotic therapy was not \u2018on-target\u2019 (Relative risk (RR): 2.2, 95% CI 1.06\u20134.9). To conclude gram-negative septicaemia constituted 60% of the burden of neonatal sepsis. Klebsiella pneumonia was the predominant organism. Multidrug resistant organisms were highly prevalent. Initial empirical antibiotic therapy was not \u2018on-target\u2019 more than 50% of the time and was associated with higher mortality.<\/jats:p>","DOI":"10.1093\/tropej\/fmaf020","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T23:02:01Z","timestamp":1751065321000},"source":"Crossref","is-referenced-by-count":4,"title":["High prevalence of antimicrobial resistance to initial empirical antibiotic therapy in neonatal sepsis in Bengaluru, India\u2014a multicentre study"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-0939","authenticated-orcid":false,"given":"Abhishek Somasekhara","family":"Aradhya","sequence":"first","affiliation":[{"name":"Department of Neonatology, Ovum Woman & Child Speciality Hospital , Hoskote, Bangalore Rural 562114, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8212-2655","authenticated-orcid":false,"given":"Prathik","family":"Bandiya","sequence":"additional","affiliation":[{"name":"Indira Gandhi Institute of Child Health , Bengaluru 560029, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6259-3118","authenticated-orcid":false,"given":"Shivashankar","family":"Diggikar","sequence":"additional","affiliation":[{"name":"Ovum Women and Child Specialty Hospital , Kalyan Nagar, Bengaluru 560043, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2061-6043","authenticated-orcid":false,"given":"Vimal Kumar","family":"U","sequence":"additional","affiliation":[{"name":"Chinmaya Mission Hospita , Bengaluru 560038, Karnataka,","place":["India"]},{"name":"l , Bengaluru 560038, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7603-6366","authenticated-orcid":false,"given":"M V","family":"Krithika","sequence":"additional","affiliation":[{"name":"Ramaiah Medical College , Bengaluru 560054, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5460-6268","authenticated-orcid":false,"given":"Bharathi","family":"Balachander","sequence":"additional","affiliation":[{"name":"St. John\u2019s Medical College Hospital , Bengaluru 560034, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2272-0004","authenticated-orcid":false,"given":"Venugopal","family":"Reddy I","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Ovum Woman & Child Speciality Hospital , Hoskote, Bangalore Rural 562114, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrakala","family":"BS","sequence":"additional","affiliation":[{"name":"St. John\u2019s Medical College Hospital , Bengaluru 560034, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Bhavana","sequence":"additional","affiliation":[{"name":"Indira Gandhi Institute of Child Health , Bengaluru 560029, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Ovum Women and Child Specialty Hospital , Kalyan Nagar, Bengaluru 560043, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Venkatagiri","sequence":"additional","affiliation":[{"name":"Chinmaya Mission Hospita , Bengaluru 560038, Karnataka,","place":["India"]},{"name":"l , Bengaluru 560038, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"G C M","sequence":"additional","affiliation":[{"name":"Ramaiah Medical College , Bengaluru 560054, Karnataka,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanekal S","family":"Gautham","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Nemours Children\u2019s Hospital, University of Central Florida College of Medicine , Orlando, FL 32827,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"RESIST Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Somasekhara","family":"Aradhya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prathik","family":"Bandiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivashankar","family":"Diggikar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vimal Kumar","family":"U","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M V","family":"Krithika","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharathi","family":"Balachander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venugopal","family":"Reddy 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