Very preterm infants are at much greater risk for early-onset sepsis (EOS) than more mature infants.

E. coli and Klebsiella spp. were the predominant organisms, and both showed high resistance rates to ampicillin and third-generation cephalosporins.

Empiric treatment should be based on regional EOS pathogen distribution and resistance rates.

This study highlights the need for improved EOS treatment guidance in LMICs.