Trends in Identification, Etiology, and Resistance Profiles of Bacterial Isolates and Appropriate Therapy for Neonatal Sepsis in Low- and Middle-Income Countries: a Narrative Review

Purpose of Review We examine how the diagnosis, etiology, treatment, rising resistant profiles, and preventive measures for neonatal sepsis have evolved over time in low–middle-income countries (LMICs). Recent Findings There is a high burden of neonatal sepsis in LMICs. The clinical features remain non-specific making diagnosis and treatment a challenge. Blood culture is currently the gold standard for diagnosis, but its drawbacks of low yield and long turnaround times have shifted attention to biomarkers such as C-reactive protein which cannot identify isolates or susceptibility patterns. There have been advancements in molecular assays for identifying isolates but are currently not available in most LMICs. Furthermore, increasing resistance of organisms to the first-line antibiotics have become a problem. Summary In the face of increasing antimicrobial resistance, empirical therapy for neonatal sepsis should be appropriate for each setting. Optimal treatment guidelines, antimicrobial stewardship, surveillance and infection, and prevention and control programs in low-resource settings are imperative.