Antibiotics-Basel最新文献

{"title":"Breaking Through Resistance: A Comparative Review of New Beta-Lactamase Inhibitors (Avibactam, Vaborbactam, Relebactam) Against Multidrug-Resistant Superbugs.","authors":"Ilias Karaiskos, Irene Galani, George L Daikos, Helen Giamarellou","doi":"10.3390/antibiotics14050528","DOIUrl":"10.3390/antibiotics14050528","url":null,"abstract":"<p><p>The introduction of new β-lactam-β-lactamase inhibitors (BLBLIs), such as ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/cilastatin/relebactam, expands our therapeutic options against carbapenem-resistant Gram-negative bacteria, including those pathogens for which therapeutic options are limited. These new combinations are active against ESBL-, AmpC-, and KPC-producing Enterobacterales, with the exception of ceftazidime/avibactam, which is active in vitro against OXA-48. However, one drawback that must be taken seriously by the clinician is that they are ineffective against metallo-β-lactamases as well as <i>Acinetobacter baumannii</i>. The recent introduction of aztreonam/avibactam marks a significant advancement in our therapeutic armamentarium against metallo-β-lactamase-producing pathogens. The question to be answered is whether there is a preferred, newer BLBLI combination for the treatment of KPC-producing Enterobacterales infections. This review provides a thorough analysis of the similarities and differences between these new combinations to identify the most effective treatment options. The present review aims to provide clinicians with a detailed understanding of each BLBLI treatment option to guide the optimal use of these new agents for the effective treatment of difficult infections caused by carbapenemase-producing Enterobacterales infections. This review is based on literature retrieved from PubMed, Scopus, Web of Science, and the Cochrane Library.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cefiderocol Antimicrobial Susceptibility Testing by Disk Diffusion: Influence of Agar Media and Inhibition Zone Morphology in <i>K. pneumoniae</i> Metallo-β-lactamase.","authors":"Maciej Saar, Anna Wawrzyk, Dorota Pastuszak-Lewandoska, Filip Bielec","doi":"10.3390/antibiotics14050527","DOIUrl":"10.3390/antibiotics14050527","url":null,"abstract":"<p><p>Accurate antimicrobial susceptibility testing (AST) of cefiderocol remains a diagnostic challenge, especially in infections caused by metallo-β-lactamase (MBL)-producing <i>Klebsiella pneumoniae</i>. While disk diffusion offers a cost-effective alternative to broth microdilution, it is highly sensitive to factors such as media composition and the presence of atypical colony morphology. The objective of this study was to evaluate how different agar media and interpretations of isolated colonies affect the performance and reliability of cefiderocol AST by disk diffusion. A total of 50 clinical <i>K. pneumoniae</i> MBL isolates were tested using disk diffusion on Columbia with blood, MacConkey, and chromogenic agars from three manufacturers. Inhibition zones were compared with MICs from broth microdilution. Statistical analyses included paired <i>t</i>-tests and Spearman correlation to assess media effects and zone morphology impact. Variability in inhibition zone diameters was observed between media, notably with chromogenic agar. The most consistent results were obtained using Graso Biotech and Thermo Fisher Columbia with blood agar. Isolated colonies were observed in over half the samples and, depending on how they were interpreted, led to major changes in classification accuracy. Up to 64% of results fell into the EUCAST area of technical uncertainty (ATU), and categorical agreement varied across media and interpretive criteria. Disk diffusion for cefiderocol may be used in resource-limited settings but only if rigorously standardized using validated media, consistent zone reading, and ATU-aware interpretive strategies. In borderline cases or when morphological anomalies are present, broth microdilution should be considered the sole reliable method. Clinical microbiologists are advised to exercise caution with ambiguous results and seek expert or confirmatory testing when needed.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Susceptibility Profiles of <i>Staphylococcus aureus</i> Isolates from Domestic Pigeons in Hungary in 2022.","authors":"Ádám Kerek, Ábel Szabó, Ákos Jerzsele","doi":"10.3390/antibiotics14050525","DOIUrl":"10.3390/antibiotics14050525","url":null,"abstract":"<p><p><b>Background</b>: Antimicrobial resistance (AMR) is a critical global health threat, affecting both human and veterinary medicine. Pigeons are increasingly recognized as potential reservoirs of antibiotic-resistant bacteria due to their widespread presence in urban and rural environments. The aim of this study was to determine the antimicrobial susceptibility profiles of <i>Staphylococcus aureus</i> isolates from pigeons in Hungary. <b>Methods</b>: A total of 73 <i>S. aureus</i> isolates were collected from pigeons across seven regions of Hungary in 2022. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis included correlation heatmaps, hierarchical clustering, network analysis, decision tree modeling, and Monte Carlo simulations. <b>Results</b>: The multidrug-resistant (MDR) prevalence rate was alarmingly high at 80.8%. Very high resistance rates were observed for doxycycline (97.3%), enrofloxacin (87.7%), and amoxicillin (84.9%). By contrast, low resistance rates were detected for vancomycin (5.5%) and imipenem (8.2%). Decision tree modeling identified tiamulin, enrofloxacin, and amoxicillin-clavulanate resistance as the most significant predictors of MDR status. Monte Carlo simulations predicted a mean MDR prevalence of 78.5%, indicating that the dominance of MDR strains is not merely a random phenomenon but part of a broader epidemiological pattern. <b>Conclusions</b>: These findings confirm that pigeons may serve as critical reservoirs of MDR <i>S. aureus</i> strains, posing a potential risk to public and animal health. Continued monitoring, the genetic characterization of resistant strains, and the development of effective control strategies are urgently needed. This study provides a foundation for future research aimed at understanding the biological, ecological, and epidemiological roles of pigeon-associated MDR strains.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combatting <i>Pseudomonas aeruginosa</i> with β-Lactam Antibiotics: A Revived Weapon?","authors":"Dylan W Zhao, Christopher T Lohans","doi":"10.3390/antibiotics14050526","DOIUrl":"10.3390/antibiotics14050526","url":null,"abstract":"<p><p><i>Pseudomonas aeruginosa</i> is a significant threat to public health as an aggressive, opportunistic pathogen. The use of β-lactam antibiotics such as penicillins, cephalosporins, monobactams, and carbapenems remains a front-line treatment against <i>P. aeruginosa</i>. However, the widespread use of β-lactams has led to the emergence of β-lactam-resistant isolates that significantly increase the economic burden and risk of mortality in patients. With the declining productivity of the antibiotic discovery pipeline, research has investigated synergistic agents to revive the use of β-lactam antibiotics against β-lactam-resistant <i>P. aeruginosa</i>. In this review, we summarize the mechanism of β-lactam antibiotics and provide an overview of major mechanisms associated with β-lactam resistance in <i>P. aeruginosa</i>. We then describe the background and use of three promising classes of agents that have shown extensive beneficial effects with β-lactam antibiotics against <i>P. aeruginosa</i>, namely β-lactamase inhibitors, bacteriophages, and antimicrobial peptides. The current understanding of the mechanisms of these synergistic agents is discussed. Lastly, we provide an overview of the current barriers impeding antibiotic development, and offer a glimpse into recent advances of artificial intelligence-based discovery that may serve as a new foundation for antimicrobial discovery and treatment.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Awareness and Perceptions of Antibiotic Use in Human and Veterinary Medicine in Serbia.","authors":"Gordana Belamarić, Dejana Vuković, Zoran Bukumirić, Rada Sandić Spaho, Gordana Marković","doi":"10.3390/antibiotics14050523","DOIUrl":"10.3390/antibiotics14050523","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Antimicrobial resistance (AMR) is a growing global health threat, requiring an approach that integrates human, animal, and environmental health. Public awareness and responsible antibiotic use are key to combating AMR. This study examines the knowledge, attitudes, and practices related to antibiotic use among the general population in Serbia, exploring their impact on antimicrobial stewardship efforts. <b>Methods</b>: A cross-sectional study was conducted in December 2022 using a three-stage stratified random sample of the Serbian population. The Eurobarometer questionnaire was utilized with permission from the European Commission. Statistical analyses included multivariate ordinal logistic regression to identify predictors of desirable attitudes and behaviors related to antibiotic use. <b>Results</b>: Almost two-thirds of respondents (61.6%) reported not receiving any advice on rational antibiotic use, underscoring the need for education of the general population and raising awareness. A Higher Antibiotic Knowledge Score was associated with a 60% greater likelihood of favorable attitudes and a 21% greater likelihood of rational antibiotic use. Pharmacists were identified as the primary source of antibiotic-related information for the general population in Serbia, but there is limited public interest and awareness of antibiotic use in animals, as well as of the bans on using antibiotics to stimulate growth in farm animals within the EU. <b>Conclusions</b>: Through targeted educational interventions, strengthening interdisciplinary collaboration and AMR control measures is necessary for human and veterinary medicine. Although pharmacists are the primary source of information about antibiotics for the population in Serbia, collaboration with physicians and their empowerment should be introduced to strengthen antimicrobial stewardship further.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vancomycin-Resistant <i>E. faecium</i>: Addressing Global and Clinical Challenges.","authors":"Daniel E Radford-Smith, Daniel C Anthony","doi":"10.3390/antibiotics14050522","DOIUrl":"10.3390/antibiotics14050522","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) poses a profound threat to modern healthcare, with vancomycin-resistant <i>Enterococcus faecium</i> (VREfm) emerging as a particularly resilient and clinically significant pathogen. This mini-review examines the biological mechanisms underpinning VREfm resistance, including biofilm formation, stress tolerance, and the acquisition of resistance genes such as <i>vanA</i> and <i>vanB</i>. It also explores the behavioural, social, and healthcare system factors that facilitate VREfm transmission, highlighting disparities in burden across vulnerable populations and low-resource settings. Prevention strategies are mapped across the disease pathway, spanning primary, secondary, and tertiary levels, with a particular focus on the role and evolving challenges of antimicrobial stewardship programmes (ASP). We highlight emerging threats, such as rifaximin-induced cross-resistance to daptomycin, which challenge conventional stewardship paradigms. Finally, we propose future directions to enhance global surveillance, promote equitable stewardship interventions, and accelerate the development of innovative therapies. Addressing VREfm requires a coordinated, multidisciplinary effort to safeguard the efficacy of existing antimicrobials and protect at-risk patient populations.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Helicobacter pylori</i> Antibiotic Resistance in Russia: A Systematic Review and Meta-Analysis.","authors":"Dmitrii N Andreev, Alsu R Khurmatullina, Igor V Maev, Dmitry S Bordin, Andrey V Zaborovskiy, Sayar R Abdulkhakov, Yury A Kucheryavyy, Filipp S Sokolov, Petr A Beliy","doi":"10.3390/antibiotics14050524","DOIUrl":"10.3390/antibiotics14050524","url":null,"abstract":"<p><p><b>Objective</b>: This systematic review and meta-analysis aims to evaluate the temporal changes in <i>Helicobacter pylori</i> antibiotic resistance in Russia based on studies published over the past 15 years. <b>Materials and Methods</b>: We conducted a comprehensive literature search in MEDLINE/PubMed, EMBASE, the Russian Science Citation Index, and Google Scholar, following the PRISMA 2020 guidelines. Our meta-analysis was pre-registered in PROSPERO (CRD 420251025636). The inclusion criteria included original research, published in English or Russian in 2011-2024, involving antibiotic susceptibility testing in treatment-naive Russian adults using validated diagnostic methods. Two independent researchers selected studies and extracted data using standardized procedures, with methodological quality assessed via the Newcastle-Ottawa Scale. Pooled resistance rates were calculated using fixed/random-effects models in MedCalc 23.1.5 and Python 3.9.21, with meta-regression investigating temporal trends and subgroup analyses examining regional and methodological variations. <b>Results</b>: We identified 16 studies comprising 1206 <i>H. pylori</i> isolates. The pooled analysis of studies (2011-2025) revealed an overall clarithromycin resistance rate of 15.236%, with a significant temporal increase from 11.903% pre-2015 to 21.024% in 2020-2024 (<i>p</i> = 0.0049). Metronidazole showed consistently high pooled resistance (33.309%), while amoxicillin (1.828%), levofloxacin (19.014%), tetracycline (1.328%), and rifampicin (5.803%) maintained low resistance rates, and dual clarithromycin-metronidazole resistance was observed in 2.793% of isolates. Regional disparities were notable in the two largest cities of Russia, with 18.763% clarithromycin resistance in Moscow versus 28.540% in Saint-Petersburg. <b>Conclusions</b>: Russia surpasses the Maastricht VI Consensus resistance threshold for clarithromycin (15%), necessitating revision of empirical treatment strategies. The significant increase in clarithromycin resistance, potentially exacerbated by antibiotic use during the COVID-19 pandemic, underscores the urgent need for resistance-guided therapies and ongoing national surveillance programs to optimize <i>H. pylori</i> management.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Susceptibility, Siderophore Production, and Genome Analysis of <i>Staphylococcus aureus</i> Clinical Isolates from a University Hospital in Chiang Mai, Thailand.","authors":"Warinda Prommachote, Manu Deeudom, Pimpisid Koonyosying, Phronpawee Srichomphoo, Ratchanee Somnabut, Phadungkiat Khamnoi, Agostino Cilibrizzi, Yuvaraj Ravikumar, Somdet Srichairatanakool","doi":"10.3390/antibiotics14050521","DOIUrl":"10.3390/antibiotics14050521","url":null,"abstract":"<p><p><b>Background/Objective:</b><i>Staphylococcus aureus</i> produces staphyloferrin A (Sfna) siderophores to sequester host iron during infection and rapid cell proliferation We examined drug susceptibility, siderophore production, and genome sequencing of clinical isolates of <i>S. aureus</i>. <b>Methods:</b> A total of 100 specimens, including pus, sputum, hemoculture, urine, tissue, fluid, and skin scrap specimens, were grown in iron-deprived Luria broth agar. The isolates were investigated for spectral signature using MALDI-TOF/MS, while antibiotic susceptibility and siderophore content were assessed using the chrome azurol S method. Whole genome and partial 16S rRNA DNA sequences were employed, and VITEK/MS revealed specific spectra. <b>Results:</b> Clindamycin, erythromycin, gentamicin, linezolid, moxifloxacin, oxacillin, trimethoprim/sulfamethoxazole, and vancomycin (100%) were the most common antibiotics to which the <i>S. aureus</i> isolates were susceptible. Sfna was not detectable in fluid and skin scrap isolates, which were encoded by <i>sfnaB</i>, <i>sfnaD</i>, and <i>sfnaB</i>/<i>sfnaD</i> genes. However, they were detectable in pus (73.8%), sputum (85.3%), hemoculture (50.0%), and urine (85.7%) isolates. The aureus subspecies, JKD6159, SA268, and MN8, were found to be 72.73% according to genome sequencing. <b>Conclusion:</b> most staphylococci in the isolates, including <i>S. aureus</i> JKD6159, SA268, and MN8, were sensitive to antibiotics and were detected by MALDI-TOF/MS, resulting in the production of Sfna encoded by <i>sfna</i> genes.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colourful Protection: Challenges and Perspectives of Antibacterial Pigments Extracted from Bacteria for Textile Applications.","authors":"Micaela Gomes, Helena P Felgueiras, Barbara R Leite, Graça M B Soares","doi":"10.3390/antibiotics14050520","DOIUrl":"10.3390/antibiotics14050520","url":null,"abstract":"<p><p>Bacterial pigments have gained significant attention across multiple industries due to their natural hues and unique functional properties. Beyond coloration, some of these pigments exhibit antibacterial activity, making them particularly valuable in the textile industry as sustainable alternatives to synthetic antimicrobial treatments. Bacteria produce a vast array of pigments through diverse biosynthetic pathways, which reflect their metabolic adaptability and ecological roles. These pathways are influenced by environmental factors such as pH, temperature, and nutrient availability. Key pigments, including carotenoids, melanin, violacein, and prodigiosin, are synthesised through distinct mechanisms, often involving tightly regulated enzymatic reactions. For example, carotenoid biosynthesis relies on isoprenoid precursors, while melanin formation involves the oxidation of aromatic amino acids. Understanding these pathways provides insights into bacterial survival strategies, stress responses, and interactions with their environment. This review examines the dyeing potential of bacterial pigments on natural and synthetic fabrics, highlighting advancements in environmentally friendly extraction methods to minimise the ecological impact. Additionally, it explores safety, biocompatibility, and industrial challenges associated with bacterial pigment applications. Finally, future perspectives on integrating these pigments into various industries are discussed, emphasising their potential as bio-based solutions for sustainable and functional materials.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Susceptibility of Early-Onset Sepsis Pathogens to the Combination of Ampicillin and Gentamicin Among Neonates in Thailand.","authors":"Anucha Thatrimontrichai, Pattima Pakhathirathien, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate","doi":"10.3390/antibiotics14050519","DOIUrl":"10.3390/antibiotics14050519","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Empirical antimicrobial therapy for neonatal early-onset sepsis (EOS) comprises ampicillin and gentamicin. However, multidrug-resistant organisms are increasing worldwide, thus inflicting a global burden. We identified the incidence and risk factors of neonates with pathogenic isolates that were not susceptible to treatment comprising a combination of ampicillin and gentamicin (non-susceptible group). <b>Methods</b>: This retrospective study included neonates diagnosed with EOS between 2004 and 2023. All patients with EOS and positive culture results within 72 h of birth were reviewed. Patients in the non-susceptible and susceptible groups were analyzed using a multivariable logistic regression model. <b>Results</b>: Sixty pathogenic isolates and 55 neonates with EOS were observed over the course of 20 years. The incidence and case fatality rates of EOS were 0.88 per 1000 live births and 41.8%, respectively. <i>Acinetobacter baumannii</i> was the most common EOS pathogenic isolate (19/60 pathogenic isolates; 12/19 resistant to carbapenems). Pathogenic isolates were susceptible to ampicillin or gentamicin (59%), ampicillin or cefotaxime (42%), and ampicillin or amikacin (72%). Data regarding susceptibility to ampicillin and gentamicin of 49 neonates were available. A multivariable analysis revealed that patients in the non-susceptible group (<i>n</i> = 18) were more likely to experience late-onset EOS (48-72 h; <i>p</i> = 0.01) and require endotracheal intubation on day 1 (<i>p</i> = 0.04) compared to patients in the susceptible group (<i>n</i> = 31). <b>Conclusions</b>: In areas with high multidrug resistance, broader-spectrum antibiotic therapy (ampicillin plus amikacin) should be considered for neonates who develop clinical sepsis within 48-72 h of birth and experience respiratory failure at birth.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}