Abstract

Neonates in Neonatal Intensive Care Units (NICUs) are highly vulnerable to hospital-acquired infections (HAIs), while the rising antimicrobial resistance (AMR) is a major treatment challenge. This study aimed to determine the prevalence and types of pathogens contaminating patient care equipment (PCEs) in the NICU and to evaluate antimicrobial susceptibility profiles, focusing on multidrug-resistant (MDR) strains. A cross-sectional study was conducted in three hospitals. A total of 67 patient-care devices frequently in contact with neonates, such as cannulas, orogastric (OG) tubes, nasogastric (NG) tubes, suction tubes, and oxygen nebulizers, were swabbed and cultured on selective and differential media. Bacterial isolates were identified by Gram staining, standard biochemical tests, and confirmed by 16S rRNA sequencing. Antimicrobial susceptibility was determined by the Kirby-Bauer disk diffusion method. Data were analyzed by SPSS (v. 29) and GraphPad Prism (8.0.2). A total of six bacterial species were identified, with Gram-negative bacteria predominating (62%) across all patient-care equipment types, and the overall multidrug-resistance rate was 76.19%. Cannulas and OG tubes showed colonization by Staphylococcus warneri, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Bacillus cereus, while Alcaligenes faecalis was mainly recovered from NG tubes. Colistin showed the highest antimicrobial efficacy (90–100% sensitivity). Low-birth-weight neonates (≤2500 g) exhibited the highest infection risk (70%) compared with those of normal (2500–4000 g) or high birth weight (≥4000 g). In conclusion, the study emphasizes the need for infection surveillance, strict disinfection, and judicious antibiotic use to curb neonatal HAIs in the NICU.

Key words: Birth Weight, Hospital-acquired infection, Multidrug-Resistance, Neonates, Patient care devices