Prevalence and risk factors for multidrug-resistant bacterial infections in low birth weight neonates admitted in selected Addis Ababa public Hospitals, Ethiopia

Abstract

Background: Multidrug-resistant (MDR) bacterial infections pose a serious threat to neonatal care, particularly among low birth weight (LBW) neonates in low- and middle-income countries. Understanding the prevalence and associated risk factors is crucial for improving management and prevention strategies. There remains a gap in understanding the specific prevalence and contributing risk factors among LBW neonates, especially in the study area. Objective: To assess the Prevalence and risk factors for multidrug-resistant bacterial infections in low birth weight neonates in Addis Ababa public hospitals, Ethiopia, 2025. Methods: An institution-based retrospective cross-sectional study was conducted from January 5 to February 5, 2024, in selected public hospitals. Neonates' charts were systematically reviewed using a structured checklist. Data were collected via the Kobo Toolbox and analyzed using IBM SPSS version 26. Logistic regression analysis was employed to identify associated risk factors, with statistical significance set at p<0.05. Result: Among 296 neonates, the prevalence of MDR bacterial infections was 24.66%. The most frequently isolated MDR pathogens included Staphylococcus aureus (20.3%), Klebsiella pneumoniae (13.9%), and Coagulase-negative Staphylococci (31.1%). Significant risk factors associated with MDR infections included prolonged rupture of membranes (AOR=2.34, 95% CI: 1.08–5.06), hospital stay >15 days (AOR=6.47, 95% CI: 1.10–38.09,), and antibiotic use for >15 days (AOR=5.60, 95% CI: 1.25–25.0). Conclusion and recommendation: The study found a relatively lower prevalence of MDR bacterial infections compared to similar studies in Ethiopia and other countries. Prolonged rupture of membranes, extended hospital stays, and prolonged antibiotic use were significant predictors of MDR infections. Strengthening infection prevention practices, optimizing antibiotic stewardship, and improving neonatal care interventions are recommended to reduce the MDR burden. Keywords: Neonates, Multidrug-resistant, Low birth weight, Neonatal Intensive Care Unit