Division of Neonatology, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.
Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, Taichung, Taiwan.
J Neonatal Perinatal Med. 2022;15(3):575-582. doi: 10.3233/NPM-210938.
We aimed to explore the epidemiology and evolution of pathogens, antibiotic susceptibility, and mortality rate in cases of neonatal early-onset sepsis (EOS) reported over a period of 12 years in a level III neonatal center in Central Taiwan.
Patients' medical records in a neonatal center from 2007 to 2018 were reviewed to obtain information on infants with culture-proven EOS, which included pathogens found in the blood or cerebrospinal fluid cultures.
The incidence of neonatal EOS during this period was 2.11 cases/1,000 admissions. Group B streptococcal (GBS) and Escherichia coli were the most common pathogens. The overall rates of GBS and E. coli infections were 0.68/1,000 and 0.77/1,000 live births, respectively. The incidence of EOS in infants with a birth weight ≥1,500 g decreased significantly with decreasing incidence of GBS-related sepsis. The incidence of EOS remained high in very-low-birth-weight (VLBW) infants and increased over time. There was an increasing trend in of E. coli infection and emergence of drug-resistant strains. In addition, E. coli sepsis had high mortality in VLBW infants.
Novel screening and prevention strategies against E. coli and reserving broad-spectrum antibiotics for the most critically ill or VLBW patients with maternal chorioamnionitis might help in early diagnosis and further improve the outcomes of EOS.
本研究旨在探讨台湾中部某三级新生儿中心 12 年间新生儿早发性败血症（EOS）的病原体流行情况、抗生素耐药性和病死率。
回顾性分析该新生儿中心 2007 年至 2018 年期间血培养或脑脊液培养阳性的 EOS 患儿的临床资料，分析其病原体、药敏结果及病死率。
该时期新生儿 EOS 的发病率为 2.11/1000 例。B 群链球菌（GBS）和大肠埃希菌是最常见的病原体。GBS 和大肠埃希菌的感染率分别为 0.68/1000 例和 0.77/1000 例活产儿。出生体重大于 1500g 的 EOS 患儿中，GBS 相关败血症的发病率随着 GBS 发病率的降低而显著降低。极低出生体重儿（VLBW）EOS 的发病率仍然较高，且呈上升趋势。大肠埃希菌感染的发生率呈上升趋势，耐药菌株的出现也有所增加。此外，大肠埃希菌败血症在 VLBW 患儿中病死率较高。
针对大肠埃希菌的新型筛查和预防策略以及对于患有绒毛膜羊膜炎的重症或 VLBW 患儿保留广谱抗生素可能有助于早期诊断并进一步改善 EOS 的预后。
