Abstract：Objective To investigate the changes in the pathogen spectrum and antimicrobial resistance over time in neonatal sepsis. Methods The medical data were collected from the neonates who were diagnosed with sepsis in the Second Xiangya Hospital of Central South University from January 2010 to December 2019. The incidence rate of sepsis, the pathogen spectrum, and the characteristics of antimicrobial resistance were analyzed. Results The incidence rate of neonatal sepsis was 4.02% (447/11 111). The top four pathogens detected were coagulase-negative staphylococci (CoNS), Klebsiella pneumoniae, Escherichia coli, and Candida. The incidence rate of sepsis and the pathogen spectrum showed no significant changes over time. Klebsiella pneumoniae was the most frequent pathogen in preterm infants, very low birth weight infants, and small-for-gestational-age infants, accounting for 33.9%, 29.5%, and 42.5%, respectively. CoNS, Klebsiella pneumoniae, and Escherichia coli had a high resistance rate to penicillins and third-generation cephalosporins. Conclusions The incidence of neonatal sepsis is high, and the main pathogen is CoNS. The pathogens of neonatal sepsis have a high resistance rate to penicillins and third-generation cephalosporins. It is recommended to enhance the prevention and control of neonatal infection, strengthen the surveillance of pathogens, and further standardize the rational use of antibiotics.
YU Yuan-Qiang,DONG Qing-Yi,HU Jin-Tao et al. A 10-year retrospective study of pathogens and antimicrobial resistance in neonatal sepsis[J]. CJCP, 2022, 24(10): 1111-1116.
Chen XC, Yang YF, Wang R, et al. Epidemiology and microbiology of sepsis in the mainland of China in the first decade of the 21st century[J]. Int J Infect Dis, 2015, 31: 9-14. PMID: 25455799. DOI: 10.1016/j.ijid.2014.11.027.
Gao K, Fu J, Guan X, et al. Incidence, bacterial profiles, and antimicrobial resistance of culture-proven neonatal sepsis in South China[J]. Infect Drug Resist, 2019, 12: 3797-3805. PMID: 31819560. PMCID: PMC6899077. DOI: 10.2147/IDR.S223597.
Al-Taiar A, Hammoud MS, Cuiqing L, et al. Neonatal infections in China, Malaysia, Hong Kong and Thailand[J]. Arch Dis Child Fetal Neonatal Ed, 2013, 98(3): F249-F255. PMID: 22942104. DOI: 10.1136/archdischild-2012-301767.
Jiang S, Yang C, Yang C, et al. Epidemiology and microbiology of late-onset sepsis among preterm infants in China, 2015-2018: a cohort study[J]. Int J Infect Dis, 2020, 96: 1-9. PMID: 32209419. DOI: 10.1016/j.ijid.2020.03.034.
Cailes B, Kortsalioudaki C, Buttery J, et al. Epidemiology of UK neonatal infections: the neonIN infection surveillance network[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(6): F547-F553. PMID: 29208666. DOI: 10.1136/archdischild-2017-313203.
Yu YQ, He XR, Wan LJ, et al. Etiology, antimicrobial resistance, and risk factors of neonatal sepsis in China: a systematic review and meta-analysis from data of 30 years[J]. J Matern Fetal Neonatal Med, 2021, 1-10. PMID: 34470123. DOI: 10.1080/14767058.2021.1951217. Epub ahead of print.
Lu Q, Zhou M, Tu Y, et al. Pathogen and antimicrobial resistance profiles of culture-proven neonatal sepsis in Southwest China, 1990-2014[J]. J Paediatr Child Health, 2016, 52(10): 939-943. PMID: 27500793. DOI: 10.1111/jpc.13278.
Schrag SJ, Farley MM, Petit S, et al. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014[J]. Pediatrics, 2016, 138(6): e20162013. PMID: 27940705. DOI: 10.1542/peds.2016-2013.
Li JY, Chen SQ, Yan YY, et al. Identification and antimicrobial resistance of pathogens in neonatal septicemia in China: a meta-analysis[J]. Int J Infect Dis, 2018, 71: 89-93. PMID: 29689386. DOI: 10.1016/j.ijid.2018.04.794.
Zhang J, Folgori L, Hsia Y, et al. Pattern of antimicrobial resistance in bloodstream isolates from Chinese neonates[J]. Pediatr Infect Dis J, 2019, 38(6): 600-604. PMID: 30672894. DOI: 10.1097/INF.0000000000002246.
Tang XJ, Sun B, Ding X, et al. Changing trends in the bacteriological profiles and antibiotic susceptibility in neonatal sepsis at a tertiary children's hospital of China[J]. Transl Pediatr, 2020, 9(6): 734-742. PMID: 33457294. PMCID: PMC7804488. DOI: 10.21037/tp-20-115.
