<![CDATA[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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