Grace LiJulia Anna BielickiA. S.M.Nawshad Uddin AhmedMohammad Shahidul IslamEitan Naaman BerezinClery B. GallacciRuth GuinsburgCarlos Eduardo Da Silva FigueiredoRosilene Santarone VieiraAndre Ricardo SilvaCristiane TeixeiraPaul TurnerLadin NhanJaime OrregoPaola Marsela PérezLifeng QiVassiliki PapaevangelouPinelope TriantafyllidouElias IosifidisEmmanuel RoilidesKosmas SarafidisDasaratha Ramaiah JinkaRaghuprakash Reddy NayakantiPraveen KumarVikas GautamVinayagam PrakashArasar SeeralarSrinivas MurkiHemasree KandrajuSanjeev SinghAnil KumarLeslie LewisJayashree PukayasthaSushma NangiaK. N. YogeshaSuman ChaurasiaHarish ChellaniStephen ObaroAngela DramowskiAdrie BekkerAndrew WhitelawReenu ThomasSithembiso Christopher VelaphiDaynia Elizabeth BallotTrusha NanaGary ReubensonJoy FredericksSuvaporn AnugulruengkittAnongnart SirisubPimol WongSorasak LochindaratSuppawat BoonkasidechaKanchana PreedisripipatTim R. CresseyPongsatorn PaopongsawanPagakrong LumbiganonDounghatai PongpanutPra Ornsuda SukrakanchanaPhilippa MusokeLinus OlsonMattias LarssonPaul T. HeathMichael SharlandShenzhen Children's HospitalFundación Valle del LiliMulago HospitalMakerere UniversityGovernment General Hospital ChennaiSt George's University of LondonNational and Kapodistrian University of AthensChulalongkorn UniversityDhaka Shishu HospitalLady Hardinge Medical CollegeFundacao Oswaldo CruzKhon Kaen UniversityVMMC &amp; Safdarjang HospitalUniversity of WitwatersrandKasturba Medical College, ManipalAttikon University HospitalAristotle University of ThessalonikiUniversidade Federal de Sao PauloFaculdade de Ciencias Medicas da Santa Casa de Sao PauloKarolinska InstitutetFaculty of Medicine, Siriraj Hospital, Mahidol UniversityTygerberg HospitalQueen Sirikit National Institute of Child HealthAll India Institute of Medical Sciences, New DelhiAmrita Institute of Medical Sciences IndiaUniversitäts-Kinderspital beider BaselUniversidade Federal FluminenseUniversiteit StellenboschPostgraduate Institute of Medical Education &amp; Research, ChandigarhInternational Foundation Against Infectious Disease in NigeriaRural Development Trust HospitalCambodia Oxford Medical Research UnitPhayao HospitalChiangrai Prachanukroh HospitalFernandez HospitalAngkor Hospital for ChildrenProntobaby Hospital da Criança2020-01-272020-01-272020-01-01Archives of Disease in Childhood. Vol.105, No.1 (2020), 26-3114682044000398882-s2.0-85071514890https://repository.li.mahidol.ac.th/handle/20.500.14594/49678© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR). Design A web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns. Setting 39 NNUs from 12 countries. Patients Any neonate admitted to one of the participating NNUs. Interventions This was an observational cohort study. Results The number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions <32 weeks ranged from 0% to 19%, and the majority of units (26/39, 66%) use Essential Medicines List 'Access' antimicrobials as their first-line treatment in neonatal sepsis. Cephalosporin resistance rates in Gram-negative isolates ranged from 26% to 84%, and carbapenem resistance rates ranged from 0% to 81%. Glycopeptide resistance rates among Gram-positive isolates ranged from 0% to 45%. Conclusion AMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.Mahidol UniversityMedicineArticleSCOPUS10.1136/archdischild-2019-316816