Tackling Antimicrobial Resistance in Neonatal Infections

Dear Colleagues,

Further progress in decreasing child mortality depends on reducing the 2.5 million neonatal deaths each year, of which 23% are directly due to infection. In both resource-poor and resource-rich settings, the clinical diagnosis of severe bacterial infections (SBI) is often challenging in neonates since symptoms and signs can be non-specific and difficult to detect. Appropriate empirical treatment of SBI is crucially important in reducing mortality. However, it requires knowledge of the relative proportions of causative organisms at a local level as well as their resistance patterns collected using standardized methods. Multidrug-resistant (MDR) pathogens are now a challenge in both high-income and low/middle-income countries. Neonates admitted to Neonatal Intensive Care Units (NICU), especially premature infants, have been identified to be at high risk for the selection and transmission of MDR pathogens. Recently, the first estimate of neonatal deaths attributable to resistant sepsis was published, with antimicrobial resistance potentially responsible for around 30% of all global neonatal sepsis deaths. However, very few data are available on the impact of resistance profiles, virulence factors, appropriateness of empirical treatment, and clinical characteristics on patients’ mortality.

With this Special Issue, as part of the scientific community, we aim to foster international research to deepen the role of the main determinants leading to adverse outcomes in newborns with SBI. Improved surveillance programs collecting neonatal AMR data and clinical outcomes are critical to allowing benchmarking and designing properly targeted interventions to decrease mortality. Future studies need to focus on improving mortality outcomes and defining the attributable burden of AMR in this population.

High-quality reviews and original studies are both welcome. We are particularly interested in the following topics:

• Epidemiology and impact of AMR in neonatal intensive care;
• Relationship between colonization and infections;
• Correlation between resistance and virulence factors/genes;
• Antimicrobial stewardship programs in neonatal settings;
• Outbreaks of MDR rods in NICU.

Dr. Laura Folgori
Dr. Ilia Bresesti
Dr. Lucia Barcellini
Guest Editors

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• Infant, Newborn
• Intensive care units
• Neonatal
• Bacteremia
• Drug Resistance
• Microbial
• Virulence factors
• Mortality
• Antimicrobial stewardship
• Outbreaks