Risk Factors for Extended-Spectrum Beta-Lactamase-Producing Bacteria among Neonates in a Referral Hospital in East Lombok, Indonesia

Resna Hermawati; Metta Octora; Astri Ferdiana

doi:10.70716/mohr.v4i3.829

Authors

Resna Hermawati Master of Public Health Programme, Faculty of Medicine and Health Sciences, University of Mataram, Mataram, Indonesia
Metta Octora Master of Public Health Programme, Faculty of Medicine and Health Sciences, University of Mataram, Mataram, Indonesia https://orcid.org/0000-0001-8440-2573
Astri Ferdiana Master of Public Health Programme, Faculty of Medicine and Health Sciences, University of Mataram, Mataram, Indonesia https://orcid.org/0000-0003-0666-4302

DOI:

https://doi.org/10.70716/mohr.v4i3.829

Keywords:

antimicrobial resistance, ESBL, Neonates, risk factors, klebsiella pneumonia

Abstract

Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria were an emerging cause of neonatal infections. However, local data from resource-limited hospitals in eastern Indonesia remained scarce. This study determined the proportion of ESBL production among Gram-negative isolates and analyzed the association of demographic and clinical characteristics with ESBL positivity in neonates. A retrospective cross-sectional study was conducted at a referral hospital in East Lombok, Indonesia, between January 2023 and December 2024. Secondary data were obtained from 117 neonates with Gram-negative isolates. Antimicrobial susceptibility testing was performed using the VITEK 2 Compact system. Data were analyzed using chi-square and multivariable logistic regression. Of 117 neonates, 56 (47.9%) harbored ESBL-producing isolates, most commonly Klebsiella pneumoniae and Serratia marcescens. Early neonatal age was the only factor independently associated with ESBL positivity (adjusted OR 49.40; 95% CI 14.86-164.17), whereas sex, gestational age, and birth weight were not. Early neonatal age was strongly associated with ESBL positivity, suggesting a possible role of maternal or perinatal colonization. These findings supported heightened vigilance and judicious empirical antibiotic use, particularly in the early neonatal period in resource-limited settings.

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