Epidemiology and Drug Resistance of Neonatal Bloodstream Infection Pathogens in East China Children’s Medical Center From 2016 to 2020

Abstract

IntroductionTo analyze the pathogen distribution and drug resistance of newborns with bloodstream infection (BSI) to help clinicians choose the appropriate empirical antibiotic therapy for clinical infection control.MethodsA total of 707 neonatal BSI cases were retrospectively analyzed. The bacteria in blood culture-positive samples were cultured, identified, and analyzed for drug sensitivity by routine methods. Statistical software was used to compare and analyze the basic data, pathogenic information, and drug resistance of the main bacteria.ResultsThe 5-year average positive rate of neonatal blood culture was 2.50%. The number of specimens submitted for inspection in 2020 significantly decreased. The top five infectious pathogens with the highest proportion were coagulase-negativeStaphylococcus(67.35%), of whichStaphylococcus epidermidishad the highest proportion (31.26%), followed byEscherichia coli(12.87%),Klebsiella pneumoniae(9.05%),Streptococcus agalactiae(8.63%), andStaphylococcus aureus(3.25%). Gram-positive (G+) bacteria were dominant, accounting for 69.45%. The main G+bacteria had a higher rate of resistance to erythromycin and penicillin G. The main Gram-negative (G–) bacteria had a high resistance rate to a variety of antibacterial drugs, especially cephalosporin antibiotics. The overall resistance ofK. pneumoniaewas higher than that ofE. coli. The top two fungi detected wereCandida parapsilosisandCandida albicans. C. parapsilosisdid not appear to be resistant to antibiotics, whileC. albicanswas resistant to multiple antibiotics. The type of microbial infection had a statistically significant difference in the positive rate among the age at delivery and wards (p< 0.05). There were significant differences in the detection of fungi among these groups (p< 0.05). The positive rate of G+bacteria in the term newborns was significantly higher than that in the preterm newborns (p< 0.05). Preterm newborns are more susceptible to pneumonia.ConclusionG+bacteria are the main pathogens of neonatal BSI. Preterm newborns are more likely to be infected with G–bacteria.E. coliandK. pneumoniaeare the most common G–bacteria, and both have a high resistance rate to a variety of antibacterial drugs. According to the distribution characteristics and drug resistance, it is very important to select antibiotics reasonably.