Authors : Tokeshwar Kumar Sahu, Praful Patil, Mridula Parganiha, Jaishriram Rathored
DOI : 10.18231/j.ijmr.13424.1771576109
Volume : 13
Issue : 1
Year : 2026
Page No : 3-11
Neonatal sepsis remains a leading cause of neonatal mortality in India, compounded by a high incidence of infection and escalating antimicrobial resistance. This review synthesizes Indian multicentre and single-centre studies published between 2010 and 2024 to characterize pathogen distribution, resistance trends, diagnostic limitations, clinical management gaps, and infection-control challenges in neonatal intensive care units. A structured literature search of PubMed, Scopus, Web of Science and Google Scholar was performed; eligible studies reporting microbial etiology, antimicrobial-susceptibility, diagnostics or infection- prevention in Indian neonates were included. Across settings Gram-negative bacilli—principally Klebsiella pneumoniae, Acinetobacter spp. and Escherichia coli—predominate and display high rates of resistance to aminoglycosides and third-generation cephalosporins, with rising carbapenem resistance; Gram- positive organisms (Staphylococcus aureus, coagulase-negative staphylococci) and fungal pathogens remain important contributors, especially in late-onset and device-associated infections. Diagnostic sensitivity is limited by low blood-culture yield and restricted access to molecular assays, driving prolonged empirical broad-spectrum therapy. We outline an implementation-oriented roadmap emphasizing strengthened diagnostics, local antibiogram-guided empiric therapy, embedded antimicrobial stewardship, improved infection-control infrastructure, and targeted research priorities including neonatal pharmacokinetic trials and maternal immunization strategies. This India-focused synthesis integrates recent multicentre evidence with regional data to offer actionable recommendations for reducing neonatal mortality while curbing antimicrobial resistance.