Vertical Transmission of Extended-Spectrum β-Lactamase (ESBL)-Producing Escherichia coli Infection in Premature Neonates: An Emerging Concern in Developed Countries.

Early-onset neonatal sepsis (EONS) is predisposed by maternal colonisation and neonatal risk factors. We present two cases of preterm neonates with vertically transmitted extended-spectrum β-lactamase (ESBL)-producing Escherichia coli sepsis. In the United Kingdom (UK), the common organisms causing EONS episodes are susceptible to the routinely used first-line empirical antibiotics, i.e., benzylpenicillin and gentamicin. These cases observed in a local neonatal unit highlight the growing concern of drug-resistant E. coli infections in this highly vulnerable age group. Gram-negative bacterial sepsis in preterm neonates is associated with long-term morbidity and mortality. Reflecting on our cases, early identification through routine maternal screening in high-risk mothers may enhance clinical suspicion and timely intervention, resulting in better clinical outcomes.