Challenge of antimicrobial-resistant organisms in neonatal intensive care units: a comprehensive review

The escalation of antibiotic-resistant organisms (AROs) represents a formidable challenge to clinical practice and public health globally. Within the landscape of Gram-positive pathogens, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci remain the most prevalent threats. Concurrently, the rise of Gram-negative AROs, including multidrug-resistant Escherichia coli , Klebsiella pneumoniae and carbapenem-resistant Enterobacterales, has severely curtailed available therapeutic options. These pathogens are associated with significant morbidity and mortality in neonatal intensive care units, where the combination of immunological immaturity and the requirement for invasive interventions places infants at heightened risk. This narrative review synthesises current evidence regarding the microbiology, evolving epidemiology and preventative strategies for AROs within neonatal healthcare settings.