ArticlePloS one2021
Prevalence and risk factors for antimicrobial resistance among newborns with gram-negative sepsis.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07563504 (Term Prelabour Rupture of Membranes Antibiotic Prophylaxis), which is not on this map. Cited by 34 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Term Prelabour Rupture of Membranes Antibiotic Prophylaxis (PROMab) Trial
Who cites it
34 citing papers in PubMed, 5 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Influence of probiotics on faecal antibiotic resistome in neonates: a systematic review.Pediatric research · 2026Pooled it
- The role of breastfeeding in modulating antimicrobial resistance in neonates: a systematic review.Pediatric research · 2026Pooled it
- Prevalence of Enterobacterales Producing Extended-Spectrum Beta-Lactamases According to One Health Approach in Burkina Faso: A Systematic Review with Meta-Analysis.Journal of epidemiology and global health · 2026Pooled it
- Prevalence and pathogen profiles of bacteremia in neonates hospitalized for clinical Sepsis in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Prevalence of carbapenem-resistant gram-negative bacteria among neonates suspected for sepsis in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Risk factors for multidrug resistance and mortality in healthcare-associated neonatal gram-negative bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Impact of targeted infection prevention and control interventions on bloodstream infections and colonization with carbapenem-resistant organisms among hospitalized neonates, Bangladesh, 2023-2024.Antimicrobial resistance and infection control · 2026Article
- Prevalence of extended-spectrum β-lactamase and carbapenemase-producing Klebsiella pneumoniae in humans, animals and the environment in Northwest Amhara, Ethiopia.Scientific reports · 2026Article
- Neonatal Infections Caused by Multidrug-Resistant Bacteria: An Analysis of Prevalence, Risk Factors, and Therapeutic Implications-A Narrative Review.Pathogens (Basel, Switzerland) · 2026Review
- Bacterial and fungal infections in infants born before 24 weeks' gestation: a review.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Clinical Characteristics and Early Evolution of Neonates with Perinatal Gram-Negative Bacterial Infections.Children (Basel, Switzerland) · 2025Article
- Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study.Pathogens (Basel, Switzerland) · 2025Observational
- Trends in incidence of neonatal late-onset sepsis in very low birth weight infants: a 15-year Brazilian single center analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Article
- Investigating the Therapeutic Mechanisms of Honeysuckle (China) in Sepsis Through Network Pharmacology and Experimental Validation.Infection and drug resistance · 2025Article
- Article
- Observational
- Molecular and clinical insights into extended-spectrum β-lactamase genes of Klebsiella pneumoniae isolated from neonatal sepsis in Ethiopia.BMC infectious diseases · 2024Article
- Magnitude and antimicrobial susceptibility profile of bacteria isolated from pediatric sepsis cases at University of Gondar Hospital, Northwest Ethiopia.BMC pediatrics · 2024Article
- Hospital Acquired Sepsis, Disease Prevalence, and Recent Advances in Sepsis Mitigation.Pathogens (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 4 countries.
Funding
Abstract
introductionNewborn sepsis accounts for more than a third of neonatal deaths globally and one in five neonatal deaths in Ethiopia. The first-line treatment recommended by WHO is the combination of gentamicin with ampicillin or benzylpenicillin. Gram-negative bacteria (GNB) are increasingly resistant to previously effective antibiotics.
objectivesOur goal was to estimate the prevalence of antibiotic-resistant gram-negative bacteremia and identify risk factors for antibiotic resistance, among newborns with GNB sepsis.
methodsAt a tertiary hospital in Ethiopia, we enrolled a cohort pregnant women and their newborns, between March and December 2017. Newborns who were followed up until 60 days of life for clinical signs of sepsis. Among the newborns with clinical signs of sepsis, blood samples were cultured; bacterial species were identified and tested for antibiotic susceptibility. We described the prevalence of antibiotic resistance, identified newborn, maternal, and environmental factors associated with multidrug resistance (MDR), and combined resistance to ampicillin and gentamicin (AmpGen), using multivariable regression.
resultsOf the 119 newborns with gram-negative bacteremia, 80 (67%) were born preterm and 82 (70%) had early-onset sepsis. The most prevalent gram-negative species were Klebsiella pneumoniae 94 (79%) followed by Escherichia coli 10 (8%). Ampicillin resistance was found in 113 cases (95%), cefotaxime 104 (87%), gentamicin 101 (85%), AmpGen 101 (85%), piperacillin-tazobactam 47 (39%), amikacin 10 (8.4%), and Imipenem 1 (0.8%). Prevalence of MDR was 88% (n = 105). Low birthweight and late-onset sepsis (LOS) were associated with higher risks of AmpGen-resistant infections. All-cause mortality was higher among newborns treated with ineffective antibiotics.
conclusionThere was significant resistance to current first-line antibiotics and cephalosporins. Additional data are needed from primary care and community settings. Amikacin and piperacillin-tazobactam had lower rates of resistance; however, context-specific assessments of their potential adverse effects, their local availability, and cost-effectiveness would be necessary before selecting a new first-line regimen to help guide clinical decision-making.
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