# Pathogen Profiles and Antimicrobial Resistance Patterns of Neonatal Sepsis in the Gulf Cooperation Council: A Systematic Review

## TL;DR

This study reviews neonatal sepsis in the Gulf Cooperation Council, identifying common pathogens and their resistance to antibiotics.

## Contribution

The study provides updated insights into neonatal sepsis pathogens and antimicrobial resistance patterns specific to the GCC region.

## Key findings

- Coagulase-negative staphylococci (CoNS) and Klebsiella spp. were the most common pathogens causing neonatal sepsis.
- CoNS showed high resistance to oxacillin and erythromycin, while Klebsiella spp. were resistant to ampicillin, amoxicillin, and ceftriaxone.
- The study highlights the need for improved surveillance and advanced diagnostics to address antimicrobial resistance in neonatal care.

## Abstract

Background: Neonatal sepsis (NS) is a life-threatening condition in newborns, which is an infectious process with a systemic inflammatory reaction to bacterial, viral, or fungal infection acquired in the first 28 days of life. Methods: This study examines the major pathogens causing neonatal sepsis in the Gulf Cooperation Council (GCC) and their resistance patterns to antimicrobial agents. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to develop this systematic review to follow a systematic and transparent process. The comprehensive literature review was done in several national and global databases, which include PubMed, Scopus, Google Scholar, Embase, and Cochrane Library. The key words inserted in the search strategy were “neonatal sepsis,” “late-onset sepsis,” “early-onset sepsis,” and “Gulf Cooperation Council (GCC),” and the keywords of antimicrobial resistance and pathogens were used: “antimicrobial drug resistance” and “pathogens.” Only articles published from January 1983 to January 2025 were included for screening. Results: The final count of the articles that fit the inclusion criteria is 54, and 5177 neonatal sepsis cases’ data have been identified. The most common pathogens were coagulase-negative staphylococci (CoNS) and Klebsiella spp., which caused 17.4 percent (901 cases) and 15.9 percent (825 cases) of neonatal sepsis, respectively. Coagulase-negative staphylococci (CoNS) were the most resistant, especially to oxacillin and erythromycin. The most isolated pathogens among Gram-negative spp. were Klebsiella spp., which showed a resistance to ampicillin, amoxicillin, and ceftriaxone. Conclusions: The bacterial isolates had a diversity of antimicrobial resistance, stressing the necessity of continuous hospital surveillance. Sophisticated diagnostic methods and well-designed research are necessary, especially in areas characterized by high rates of neonatal mortality, to determine the prevalence of neonatal sepsis, risk factors, and clinical outcomes.