This study measures the burden of healthcare-associated sepsis, AMR, and mortality from neonatal sepsis at two health facilities in Ethiopia. Methods: A prospective cohort study recruited normal and low birthweight infants (LBW, <2000 grams) from two hospitals in Amhara, Ethiopia.

Mother-infant pairs were recruited at birth and followed through Day 28 of life. Neonates with suspected sepsis had blood cultures drawn to identify the etiologic agents and their antimicrobial resistance patterns. We used univariable and multivariable logistic regression to determine risk factors predictive of culture-confirmed sepsis.

Next, we performed marginal effects analysis to create a clinical tool to prospectively identify sepsis risk.

There were substantive differences in sepsis incidence and mortality risk by facility and birthweight. Conclusions: The differences in mortality, sepsis and resistance between hospitals, despite similar newborn characteristics at baseline, suggests the care environment may play a critical role in preventable sepsis risk.

Developing effective facility-based sepsis prevention strategies is an urgent priority for advancing global newborn survival.

STATA, 17