Characteristics of Neonatal Sepsis Caused by Multi-drug Resistant Organisms (MDRO) in the Neonatal Intensive Care Unit (NICU) of Ngoerah Hospital

Abstract

Neonatal sepsis caused by MDRO is a clinical syndrome where a newborn infant experiences systemic inflammation caused by a pathogen that has adapted to resist several classes of antimicrobial drugs. The mortality rate of MDRO neonatal sepsis is significantly higher compared to non-MDRO cases due to having less treatment choices. This study was conducted to determine the characteristics of neonatal sepsis caused by MDRO in the NICU of Ngoerah Hospital, to provide clinical and microbiological data as a basis for prevention and formulation of new treatment regimens. This study uses a descriptive quantitative method with a cross-sectional approach. Data was collected from the medical records of neonates who were treated in January 2022 to August 2024, using the consecutive sampling technique. A total of 34 samples were included in the study. The most common isolated gram-positive pathogen was Staphylococcus epidermidis (14.7%), while the most common gram-negative pathogens were Klebsiella pneumoniae ssp. pneumoniae (29.4%) and Acinetobacter baumannii (23.5%). The antibiotic classes that faced the most resistance were penicillin (100%), cephalosporin (97.1%), and aminoglycosides (88.2%). Other characteristics found a predominance in female infants (52.9%), low birth weight (29.4%), very preterm (32.4%), early onset sepsis (76.5%), duration of treatment 7-88 days, blood culture (91.2%), history of using invasive ventilatory devices (38.2%), no history of invasive surgery (76.5%), history of using a peripherally inserted venous catheter (41.2%), congenital anomalies of the circulatory system (55.9%), no subsequent case of meningitis (64.7%), and an outcome of death (67.7%).

Keywords: Neonatal sepsis, multi-drug resistant organism (MDRO), characteristics