Bloodstream Infections in the Neonatal Intensive Care Unit: A Systematic Review of the Literature.

Bloodstream infections represent a significant concern in neonatal intensive care units (NICUs), constituting a leading cause of morbidity and mortality among neonates. This study aimed to elucidate the etiology, prevalence, and antimicrobial resistance patterns of bloodstream infections in NICU settings. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines using the PubMed database to source relevant studies published between 2019 and 2023. Keywords related to bloodstream infections, neonates in NICUs, pathogens, resistance, and susceptibility were employed. Out of the 73 identified articles, eight met the inclusion criteria. Findings revealed a predominance of late-onset sepsis in hospitalized neonates, with Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococci, Group B Streptococcus, Acinetobacter species, Serratia marcescens, Staphylococcus aureus, and Enterobacter cloacae being the most commonly isolated pathogens. Antimicrobial susceptibility profiles demonstrated resistance among bacteria to ampicillin, gentamicin, and penicillin, while fungi exhibited resistance to amphotericin B, fluconazole, flucytosine, itraconazole, and voriconazole. These findings underscore the persistent challenge of bloodstream infections in the NICUs, particularly late-onset sepsis, emphasizing the importance of early detection and appropriate antimicrobial therapy in neonatal care management.