Neonatal Intensive Care Unit Apocalypse—Rise of the World Health Organization Priority Pathogens

This was a retrospective study analyzing the positive blood cultures of the neonates admitted with sepsis to the NICU of Sri Aurobindo Medical College (SAMC) and Postgraduate Institute (PGI), Indore, for a period of 1.5 years from April 2022 to September 2023.Waiver of consent obtained from ethical committee. Sample SizeConvenient sample size of 342 cultures was taken as per the hospital records meeting the inclusion criteria. Inclusion CriteriaAll neonates with suspected sepsis (refusal to feed, keeping dull, apnea, seizure, fever) and positive blood cultures admitted in NICU introduction Among neonatal deaths, neonatal sepsis remains the third most common cause, accounting for 225,000 deaths every year around the world. 1 The highest burden of neonatal sepsis is found in South Asia and sub-Saharan Africa. 1 A high resistance to commonly used antibiotics for the treatment of neonatal sepsis has been reported in studies done in southeast Asia. 2 The most important challenge in the management of neonatal sepsis is the alarmingly increasing resistance to multiple antibiotics. 3World Health Organization (WHO) also identified this burden and gave a list of 12 global priority pathogens (GPPs) in 2017, divided into three categories-critical, high, and medium antibiotic resistance. 4This list was given to study the global resistance to antimicrobial medicines.The selection criteria of pathogens were based on the grave outcome of individual infections and their antibiotic sensitivity.The critical class of pathogens are the ones found in patients with blood catheters or on invasive ventilation, and these include the carbapenem-resistant Acinetobacter, Pseudomonas, and various Enterobacteriaceae (including Klebsiella, Escherichia coli, Serratia, and Proteus).So, the present study was conducted to identify WHO GPPs in neonatal intensive care unit (NICU) and determine their antibiotic sensitivity. objectivesPrimary objective was to study the burden of WHO GPPs and their antibiotic sensitivity pattern.Secondary objective was to assess their virulence by studying their case fatality rate.