Published in PLOS One on 2026-07-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Asaye Mitiku, Aseer Manilal, Eyerusalem Asnake, Bamud Hussien, Binyam Debalke, Alayu Bogale, Zerihun Solomon, Gelila Birsaw
Source: PLOS One • DOI 10.1371/journal.pone.0352190
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Sepsis neonatorum (neonatal sepsis) constitutes severe, life-threatening infections, frequently necessitating intensive care unit admissions, and is a leading indication for antibiotic prescription in neonatal clinical practices. In Ethiopia, neonatal sepsis is quite rampant, and the widespread empirical therapy results in several interrelated challenges, such as incorrect or misuse of antibiotics, bacterial virulence, and aggravation of drug resistance and treatment failures.
This study was done to assess the culture-positive sepsis, antibiotic susceptibility patterns, and associated factors among neonates attending Dilla University Referral Hospital, southern Ethiopia.
A cross-sectional study was conducted from August to October 2023 among 280 neonates suspected of sepsis using systematic random sampling. Data and venous blood samples were collected and analyzed using standard microbiological procedures. Antibiotic susceptibility was tested by Kirby-Bauer disk diffusion. SPSS and logistic regression were used for analysis, with p ≤ 0.05 considered statistically significant.
The overall culture-positive prevalence (n = 88) of neonatal sepsis was 31.4% (95% CI: 25.7, 36.8). Neonatal sepsis was predominantly caused by Escherichia coli (n = 27, 30.7%), followed by Klebsiella pneumoniae (n = 18, 20.5%). Both Gram-negative and Gram-positive bacteria were extremely resistant (80–100%) to ampicillin, amoxicillin-clavulanate, ceftriaxone, and ceftazidime. Overall, 70.2% of the isolates were multi-drug resistant, including more than a quarter of isolates that were WHO prioritized, viz., methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase bacteria. Isolates exceeding one-fourth of the entire bacteria studied demonstrated resistance to both the first- and second-line regimens. Residence in rural areas [AOR: 1.43; 95% CI: 1.22–5.84 (p < 0.05)], mode of delivery by Caesarean section [AOR: 3.23; 95% CI: 1.04–9.46 (p < 0.002)], lengthy hospital stays [AOR: 4.65; 95% CI: 1.55–13.9 (p < 0.001)], prolonged labour [AOR: 3.36; 95% CI: 1.32–8.56 (p < 0.05)], and preterm premature rupture of membrane [AOR: 5.23; 95% CI: 4.11–9.49 (p < 0.001)] were statistically associated with the outcome.
A substantial prevalence of culture-confirmed cases of neonatal sepsis was identified, in comparison to other regions of the country. Alarmingly, bacterial isolates demonstrated considerable resistance to the first-and second-line regimens. Regular monitoring of antibiotic resistance patterns and timely implementation of enhanced infection prevention strategies are the need of the hour.
Introduction
Neonatal sepsis, also known as sepsis neonatorum, is a life-threatening multisystem syndrome that manifests during a period of 28 days after birth (0–28 days of life) and is the outcome of bloodstream infections. It is classified as either early- or late-onset (EOS or LOS), with each form having a distinct etiology [1]. The former, EOS, caused by the transmission of pathogens from the maternal-genitourinary system or gastrointestinal flora to the neonates or fetus, is now controlled to a greater extent, primarily due to the introduction of universal screening of Group B streptococcus in pregnant women and intrapartum antibiotic prophylaxis. However the latter continuous to cause severe challenges to many countries and usually occurs when pathogens get transmitted from the surrounding environment, after delivery and also by a late manifestation of vertically transmitted infection [2]. In the absence of prompt diagnosis and effective treatment, the condition can worsen, resulting in serious complications involving organ failures, septic shock, and even death [3]. Neonatal sepsis is a leading global cause of disability and mortality, and it continues to pose a considerable diagnostic dilemma for neonatologists, exacerbated by non-specific clinical signs and diagnostic ambiguities in early stages [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Asaye Mitiku, Aseer Manilal, Eyerusalem Asnake, Bamud Hussien, Binyam Debalke, Alayu Bogale, Zerihun Solomon, Gelila Birsaw. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Bacteriological profiles, antimicrobial resistance patterns, and predictors of culture-confirmed neonatal Sepsis at Asella Teaching Hospital, Southeast Ethiopia
- Evidence brief: Bacterial isolates and antimicrobial susceptibility profiles of pediatric meningitis at comprehensive specialized hospitals in Bahir Dar, Northwest Ethiopia
- Evidence brief: Bacterial profile and antimicrobial resistance patterns of bloodstream infections at Amhara Public Health Institute, Bahir Dar, Ethiopia
