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Volume 14
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10.3390/pathogens14060588
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Article

Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study

by
Uriel A. Angulo-Zamudio
1,
Maria Luisa Velazquez-Meza
2,
Jesus J. Martinez-Garcia
1,3,
Nidia Leon-Sicairos
1,3,
Jorge Velazquez-Roman
1,
Hector Flores-Villaseñor
1,4,
Claudia Leon-Sicairos
5,
Francisco A. Martínez-Villa
6 and
Adrian Canizalez-Roman
1,2,*
1
School of Medicine, Autonomous University of Sinaloa, Culiacan 80019, Sinaloa, Mexico
2
The Women’s Hospital, Secretariat of Health, Culiacan 80020, Sinaloa, Mexico
3
Pediatric Hospital of Sinaloa, Culiacan 80200, Sinaloa, Mexico
4
The Sinaloa State Public Health Laboratory, Secretariat of Health, Culiacan 80020, Sinaloa, Mexico
5
Regional Graduate Program in Biotechnology, Faculty of Chemical and Biological Sciences, Autonomous University of Sinaloa, Culiacan 80000, Sinaloa, Mexico
6
Unidad de Medicina Familiar No. 21, Mexican Social Security Institute, La Cruz de Elota 82700, Sinaloa, Mexico
*
Author to whom correspondence should be addressed.
Pathogens 2025, 14(6), 588; https://doi.org/10.3390/pathogens14060588
Submission received: 20 May 2025 / Revised: 12 June 2025 / Accepted: 12 June 2025 / Published: 14 June 2025
(This article belongs to the Special Issue Virulence Mechanisms Used by Pathogens Related to Human, Animal, and Environmental Health)
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Abstract

The objective of this study was to determine the epidemiological, clinical, and laboratory characteristics of newborns with sepsis in northwestern Mexico, identify the microorganisms causing early- and late-onset sepsis, and assess antimicrobial resistance. Additionally, it sought to associate neonatal characteristics with antimicrobial resistance or mortality. A retrospective study was conducted from August 2021 to April 2023, during which 8382 neonatal clinical records were analyzed to collect epidemiological, clinical, and laboratory characteristics, as well as microorganisms isolated from neonates and their antimicrobial resistance profiles. Of these, 314 neonates with sepsis were included. The incidence of neonatal sepsis was 4% (314/8382), and the mortality was 12.7% (40/314); late-onset sepsis (65.3%) was more frequent than early-onset sepsis (34.7%). Staphylococcus epidermidis was the most frequently isolated bacterium in neonates with sepsis (both early- and late-onset). Gram-positive bacteria, such as Staphylococcus hominis and Enterococcus faecium, were associated with early-onset sepsis, whereas fungi, particularly Candida albicans, were associated with late-onset sepsis. Of the microorganisms, 52.6% were multidrug resistant (MDR), 10.8% were extensively drug resistant (XDR), and 5.5% were pan-drug resistant (PDR). Low birth weight, prematurity, cesarean section, mechanical ventilation, tachycardia, and low hemoglobin and platelet levels, among others, were associated with XDR or MDR microorganisms. In contrast, low birth weight, mechanical ventilation, stroke, unexpected delivery, respiratory distress, tachycardia, convulsive crisis, high procalcitonin, urea, and AST/TGO levels, among others, were associated with mortality. The incidence, types of sepsis, antimicrobial resistance, and associations identified in this study will aid in diagnosing neonatal sepsis earlier and may reduce mortality in our region.
Keywords: neonatal sepsis; early-onset sepsis; late-onset sepsis; antimicrobial resistance; biomarkers neonatal sepsis; early-onset sepsis; late-onset sepsis; antimicrobial resistance; biomarkers
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MDPI and ACS Style

Angulo-Zamudio, U.A.; Velazquez-Meza, M.L.; Martinez-Garcia, J.J.; Leon-Sicairos, N.; Velazquez-Roman, J.; Flores-Villaseñor, H.; Leon-Sicairos, C.; Martínez-Villa, F.A.; Canizalez-Roman, A. Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study. Pathogens 2025, 14, 588. https://doi.org/10.3390/pathogens14060588

AMA Style

Angulo-Zamudio UA, Velazquez-Meza ML, Martinez-Garcia JJ, Leon-Sicairos N, Velazquez-Roman J, Flores-Villaseñor H, Leon-Sicairos C, Martínez-Villa FA, Canizalez-Roman A. Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study. Pathogens. 2025; 14(6):588. https://doi.org/10.3390/pathogens14060588

Chicago/Turabian Style

Angulo-Zamudio, Uriel A., Maria Luisa Velazquez-Meza, Jesus J. Martinez-Garcia, Nidia Leon-Sicairos, Jorge Velazquez-Roman, Hector Flores-Villaseñor, Claudia Leon-Sicairos, Francisco A. Martínez-Villa, and Adrian Canizalez-Roman. 2025. "Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study" Pathogens 14, no. 6: 588. https://doi.org/10.3390/pathogens14060588

APA Style

Angulo-Zamudio, U. A., Velazquez-Meza, M. L., Martinez-Garcia, J. J., Leon-Sicairos, N., Velazquez-Roman, J., Flores-Villaseñor, H., Leon-Sicairos, C., Martínez-Villa, F. A., & Canizalez-Roman, A. (2025). Characteristics of Neonates with Sepsis Associated with Antimicrobial Resistance and Mortality in a Tertiary Hospital in Mexico: A Retrospective Observational Study. Pathogens, 14(6), 588. https://doi.org/10.3390/pathogens14060588

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