Objective:

To explore the clinical characteristics, bacterial profiles, and antimicrobial resistance (AMR) of neonatal bloodstream infections (BSI) caused by ESKAPEEc pathogens and compare them with non-ESKAPEEc infections, focusing on the differences in clinical outcomes and treatment responses.

Key Findings:

• 55.4% of the neonates had ESKAPEEc BSI, indicating a significant prevalence that necessitates targeted treatment.
• The cohort consisted of 380 males (60.8%) and 245 females (39.2%), highlighting a male predominance.
• 89.0% of cases were classified as late-onset sepsis (LOS), which is critical for understanding the timing of interventions.
• The median age at admission was 6.1 days, with a median gestational age of 37.3 weeks, suggesting the vulnerability of late preterm and term neonates.

Interpretation:

The high prevalence of ESKAPEEc pathogens in neonatal BSI highlights the urgent need for targeted antimicrobial therapy and improved diagnostic strategies.

Limitations:

• The study was retrospective and conducted at a single center, which may limit generalizability to other settings and populations.
• Incomplete records may have led to exclusion of some cases, potentially biasing the results and affecting the overall findings.

Conclusion:

The findings underscore the importance of understanding the microbial landscape and AMR patterns in neonatal BSI to inform empirical treatment strategies, ultimately aiming to reduce morbidity and mortality associated with these infections.