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The more infants carrying antibiotic-resistant bacteria in a neonatal unit, the higher the risk for other newborns to pick them up too. A European study found that every 10-percentage-point rise in unit-level ESBL colonization was linked to 73–89% higher odds of a new infant becoming colonized. Experts say reducing colonization pressure — especially during outbreaks — is key to protecting the most vulnerable babies.
Newborns in neonatal intensive care units (NICUs) are significantly more likely to acquire antibiotic-resistant bacteria when more of their unit-mates are already carrying them, according to a new study published in JAMA Network Open. The research, conducted across 24 neonatal units in eight European countries, found that extended-spectrum beta-lactamase (ESBL)-carrying bacteria were the most common antibiotic-resistant organisms detected — present in about 1 in 7 stool samples tested.
The study tracked 943 infants over repeated surveys and found that 1 in 6 previously uncolonized infants became colonized with ESBL-carrying bacteria during follow-up. The risk climbed sharply with unit-level colonization pressure, regardless of the time interval between surveys.
By the Numbers:
Why it matters: Antibiotic-resistant infections are a leading threat to newborn survival, especially for premature or critically ill infants. This study highlights that unit-level colonization pressure is a key driver of spread, suggesting that infection control strategies — like decolonization and enhanced surveillance — should be prioritized in high-burden units and during outbreaks.
