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 …