Evidence map›Paper›PMID 39985102›Full record

ArticleAntimicrobial resistance and infection control2025

A mixed-method study on antimicrobial resistance infection drivers in neonatal intensive care units: pathways, risks, and solutions.

Almaw Genet Yeshiwas, Gashaw Melkie Bayeh, Tilahun Degu Tsega, Sintayehu Simie Tsega, Asay Alamneh Gebeyehu, Zufan Alamrie Asmare, Rahel Mulatie Anteneh, Amare Genetu Ejigu, Ahmed Fentaw Ahmed, Zeamanuel Anteneh Yigzaw and 5 more

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Almaw Genet YeshiwasDepartment of environmental health, college of medicine and health science, Injibara University, Injibara, Ethiopia.
Gashaw Melkie BayehDepartment of environmental health, college of medicine and health science, Injibara University, Injibara, Ethiopia.
Tilahun Degu TsegaDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Sintayehu Simie TsegaDepartment of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Asay Alamneh GebeyehuDepatment of Public Health, College of health science, Debre Tabor University, Debre Tabor, Ethiopia.
Zufan Alamrie AsmareDepartment of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Rahel Mulatie AntenehDepatment of Public Health, College of health science, Debre Tabor University, Debre Tabor, Ethiopia.
Amare Genetu EjiguDepartment of Midwifery, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Ahmed Fentaw AhmedDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Zeamanuel Anteneh YigzawDepartment of Health Promotion and Behavioral Sciences, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Abathun TemesgenDepartment of environmental health, college of medicine and health science, Injibara University, Injibara, Ethiopia.
Anley Shiferaw EnawgawDepartment of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Getasew YirdawDepartment of Environmental Health Science, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Wosenyelesh DesalegnDisease Prevention and Health Promotion Department Head, Epidemiologist and Infection Prevention Focal Person at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.
Chalachew Yenew *Department of Environmental Health Sciences, Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia. chalachewyenew50@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntimicrobial resistance (AMR) in neonatal intensive care units (NICUs) complicates treatment of healthcare-associated infections, causing high morbidity and mortality, especially among low-birth-weight and critically ill infants. This study evaluates AMR prevalence, risk factors, outcomes and infection control measures at Felege Hiwot Hospital, aiming to guide clinical practices, antimicrobial stewardship, and improved neonatal health outcomes.

methodsThis mixed-methods study (Oct 2022-Jun 2023) assessed AMR in NICU neonates by analyzing 420 blood samples, environmental swabs, and staff insights. Bivariable and multivariable regressions identified significant variables, and content analysis was used for qualitative data.

resultsOut of 420 samples, 35% tested positive for AMR pathogens, with Coagulase-Negative Staphylococci (16.7%), Klebsiella pneumoniae (12.9%), and Acinetobacter spp. (5.6%) being the most prevalent. Resistance rates for Gentamicin, Cotrimoxazole, and Ciprofloxacin were alarmingly high (98-100%), while Amikacin demonstrated low resistance (3.0-5.56%), indicating potential efficacy. Among the neonates admitted, 91.8% survived, and 8.2% succumbed. Risk factor analysis revealed that improper PPE usage (AOR 3.90, p < 0.001), non-functional handwashing sinks (AOR 3.20, p < 0.001), and inadequate disinfection practices (AOR 2.70, p < 0.001) were strongly associated with microbial contamination. Environmental factors, including cockroach presence (AOR 1.80, p = 0.040) and high traffic flow (AOR 2.10, p = 0.005), were also significant contributors. The qualitative data analysis confirmed that improper PPE use, inadequate disinfection practices, pest control challenges, and non-functional handwashing sinks significantly contributed to microbial contamination risks in the NICU, aligning with the quantitative findings.

conclusionsThis study underscores key factors driving AMR in NICUs, such as inadequate IPC practices and environmental contamination, alongside high resistance to Cotrimoxazole and Ciprofloxacin. Amikacin shows promise as an effective treatment for CONS. Urgent actions, including strengthened IPC measures, staff training, and environmental management, are crucial to combat AMR, ensuring improved neonatal care and outcomes.

Indexed as

Anti-Bacterial AgentsCross InfectionDrug Resistance, BacterialIntensive Care Units, NeonatalAntimicrobial StewardshipFemaleHumansInfant, NewbornInfection ControlMalePrevalenceRisk FactorsAnti-Bacterial AgentsAmikacinAntimicrobial resistance (AMR)Coagulase-negative staphylococci (CONS)Infection prevention and control (IPC)NICU

Identifiers

PMID39985102
PMCPMC11846396

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.