Neonatal sepsis in Vietnam: Bacterial profiles and antibiotic susceptibility in a tertiary care setting

Background: Neonatal sepsis is a leading cause of newborn mortality, particularly in low and middle-income countries. This study examines the bacterial etiologies and antibiotic resistance patterns of neonatal sepsis in a tertiary hospital in Vietnam.

Methods: A prospective cross-sectional study was conducted at National Children's Hospital, Hanoi, Vietnam from January 2021 to December 2022. All neonates with a clinical suspicion of sepsis and a confirmed positive blood culture were identified. Isolated pathogens were identified, and antibiotic susceptibility was assessed using standard protocols.

Results: 202 neonates were diagnosed with proven sepsis. Among these 75.2% of cases referred from other hospitals. Early-onset sepsis accounted for 15.8% of these infections. Gram-negative bacteria were responsible for 75.7% of the cases, with Klebsiella pneumoniae being the most prevalent pathogen (32.2%), followed by Staphylococcus aureus (14.9%), and both Serratia marcescens and Escherichia coli (10.9% each). Gram-negative bacteria showed significant resistance to third-generation cephalosporins, carbapenems, while Gram-positive bacteria demonstrated considerable resistance to clindamycin and oxacillin. However, most Gram-positive isolates were susceptible to vancomycin, and Gram-negative bacteria had lower resistance to colistin and fosfomycin.

Conclusions: These findings highlight the critical importance of continuous surveillance and tailored antibiotic policies to combat neonatal sepsis effectively.