Outbreaks of infection are common in the neonatal units of hospitals in low- and middle-income country (LMIC) hospitals.
Here we systematically reviewed outbreaks in LMIC neonatal units published between 2015-2025, identifying 172 outbreaks reported in 129 articles across 32 countries.
Remarkably, Gram-negative bacteria accounted for 74% of outbreaks, with Klebsiella spp. being the most frequently detected outbreak pathogen (35%).
Alarmingly, Klebsiella spp. displayed high estimated pooled proportions of resistance to third-generation cephalosporins (100%) and carbapenems (71%), as well as multidrug resistance (MDR) (89%).
For full details read the preprint here: https://www.medrxiv.org/content/10.64898/2026.10.27.26366573v2
