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Strategies to manage resistant gram-negative organisms in neonates
  1. Nimal Wickramasinghe1,
  2. Julie Suviste2,
  3. Mitul Patel1,
  4. Jim Gray1
  1. 1Department of Microbiology, Birmingham Women's Hospital, Birmingham, UK
  2. 2Department of Infection Control, Birmingham Women's Hospital, Birmingham, UK
  1. Correspondence to Dr Nimal Wickramasinghe, Department of Microbiology, Birmingham Women's Hospital, Mindelsohn Way, Edgbaston, Birmingham, West Midlands B15 2TG, UK; nwickramasinghe1{at}

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Gram-negative antibiotic resistance is currently of major concern worldwide. In the UK, the prevalence of multi-resistant gram-negative bacteria (MRGNB) is increasing,1 and outbreaks have occurred in neonatal units (NNUs).

Up to 12% of neonates undergo a septic screen at birth, and most of them receive empiric antibiotics.2 Around 70% of NNUs use narrow-spectrum penicillin/gentamicin combinations for empiric treatment of neonatal sepsis.3 However, these regimens may not be active against MRGNB. Vergnano et al4 found that Enterobacteriaceae accounted for around 20% to 35% of early- and late-onset sepsis, respectively, underlining the threat that MRGNB pose in neonatology. Unlike many other …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.