Pediatrics · Infectious Disease · 4 h ago
Meta-analysis estimates Gram-negative neonatal sepsis prevalence in Pakistan at 57%
A systematic review and meta-analysis of 54 studies involving 9,039 neonates estimated that Gram-negative bacteria caused 57% of neonatal sepsis cases in Pakistan. Resistance was highest for ampicillin, followed by amoxicillin, gentamicin and cefotaxime; estimates varied substantially by study period.
- Gram-negative bacteria accounted for 57% of pooled cases.
- Fifty-four studies included 9,039 neonates.
- Ampicillin resistance was estimated at 61.3%.
- Prevalence varied by study period.
Researchers searched PubMed, Embase and Google Scholar for studies published from 2016 through 2025 and pooled findings from 54 studies comprising 9,039 neonates with sepsis in Pakistan. Most included studies were cross-sectional; others were prospective, retrospective or descriptive. The analysis estimated the prevalence of Gram-negative bacteria and their antibiotic resistance patterns.
The pooled prevalence of Gram-negative bacteria was 57% (95% CI, 50–64). Escherichia coli, Klebsiella species and Acinetobacter species were the most frequently reported pathogens. The highest reported resistance levels were to ampicillin (61.3%), amoxicillin (50.8%), gentamicin (45.8%) and cefotaxime (42.4%). Pooled prevalence varied by study period, from 35% in 2017 to 75% in 2018.
The findings describe a substantial burden of Gram-negative neonatal sepsis and resistance in the included Pakistani studies. The wide temporal variation and predominance of cross-sectional studies are important caveats; pooled estimates do not establish current resistance patterns at individual facilities or provide a treatment recommendation. Local microbiology and susceptibility data remain important when interpreting these results.
In practice
For clinicians caring for neonates with sepsis in Pakistan, this review indicates that Gram-negative organisms were common across the included studies and reports notable resistance to several commonly used antibiotics. The pooled findings may help frame local antimicrobial surveillance and review of empiric-treatment protocols, but they do not identify the appropriate regimen for an individual infant or facility. Most studies were cross-sectional, and estimates varied markedly by study period, so local and current susceptibility results are essential to interpretation.
AI-generated clinical interpretation · Not editor-reviewed
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
BMC Public Health: The prevalence of neonatal sepsis caused by gram-negative bacteria and their antibiotic resistance patterns in Pakistan: a systematic review and meta-analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.