Antimicrobial Resistance Patterns of Bacterial Isolates from Neonatal Sepsis Cases at University of Benin Teaching Hospital, South South Nigeria

Antimicrobial resistance (AMR) is rapidly undermining treatment efficacy for neonatal sepsis in Nigeria, a setting where empirical antibiotic therapy is frequently the only available option. This retrospective cross-sectional study describes the bacterial aetiology and antimicrobial resistance patterns of blood culture isolates from neonates admitted with sepsis at the University of Benin Teaching Hospital (UBTH), Edo State, South South Nigeria, over a four-year period from 2020 to 2023. A total of 412 blood cultures were reviewed, of which 184 (44.7%) yielded significant bacterial growth. Gram-negative organisms predominated (64.1%), with Klebsiella pneumoniae (27.7%), Escherichia coli (18.5%), and Staphylococcus aureus (20.1%) being the most frequently isolated pathogens. Extended-spectrum beta-lactamase (ESBL) production was confirmed in 62.4% of Klebsiella isolates and 48.6% of Escherichia coli isolates. Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 43.2% of Staphylococcus aureus isolates. Resistance to ampicillin exceeded 85% in all Gram-negative isolates, while gentamicin resistance was 41.3%. Sensitivity to carbapenems was preserved in 76.9% of Gram-negative isolates. These findings reveal a critical mismatch between standard empirical regimens and local resistance patterns. The study advocates urgent AMR surveillance integration into neonatal units, rational antibiotic prescribing policies, and strengthening of microbiological diagnostic capacity. Keywords: antimicrobial resistance, neonatal sepsis, blood culture, UBTH, South South Nigeria.