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High-risk neonatal sepsis resulting in up to four million infants’ mortality and organ damages during the first 28 days of life predominates in low-income countries. We investigated genotypic antibiotic-resistant genes in emerging bacterial pathogens from newborn sepsis cases in Lagos.

A cross-sectional study of 294 at-risk hospitalised newborns in prominent paediatrics hospitals throughout three senatorial districts of Lagos utilised the socio-demographic data of their mothers and informed consents. We aseptically collected approximately 3 mL of venous blood from neonates, subsequently isolated and identified the associated bacteria using agar culture on Mueller Hinton agar. To evaluate the antibiotic resistance genes, we used Kirby-Bauer disc diffusion technique; MICROBACT ^TM Identification System and molecular techniques including PCR, RAPD-PCR, sequencing and docking.

From 294 patient samples, 110 (37.4%) were cultured positive, with men (47%), females (53%), ages ≤ 72 hours (71.8%), and ages > 72 hours (28.1%). Klebsiella pneumoniae, K. oxytoca, Enterobacter gergoviae, Serratia rubidiae, Escherichia coli, and Cronobacter sakazakii were the involved Gram- negative bacteria, whereas Coagulase-negative Staphylococci , Staphylococcus aureus , and Enterococcus faecalis were the involved Gram-positive bacteria. Fourteen (12.7%) positive bacteria were resistant to only three antibiotic classes, whereas 73 (66.4%) were resistant to over three antibiotics. Antibiotic- resistant genes bla-CTX, bla-SHV, and bla-TEM were found in Serratia rubidiae and Enterobacter gergoviae , unusual aetiology of newborn sepsis. Molecular docking proved Meropenem’s antibacterial effectiveness.

The identified antimicrobial-resistant genes are crucial for improved patient management, as high- resistance strains of ampicillin, gentamicin, and cefotaxime remain ineffective against bacterial sepsis, leaving Meropenem as the sole feasible therapeutic option.