Jin Zhengjiang, Wang Zhenhui, Li Jinchun, Yi Lu, Liu Nian, Luo Lan
Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, People's Republic of China.
Infect Drug Resist. 2022 Jun 9;15:2983-2993. doi: 10.2147/IDR.S367068. eCollection 2022.
To determine the distribution and antibiotic resistance patterns among pathogens that cause neonatal sepsis (NS) and to assess trends in antibiotic resistance.
A total of 864 patients with sepsis admitted to a neonatal intensive care unit (NICU) between 2014 and 2021 were enrolled. Data on neonate age and sex, pathogenic microbes, and antimicrobial susceptibility were collected. Univariate and linear regression analyses were performed to determine the differences and trends in antibiotic resistance rates.
The overall incidence rate of NS was 4.59 cases per 1000 live births. Of these cases, 255 (29.5%) were early-onset neonatal sepsis (EONS) and 609 (70.5%) were late-onset neonatal sepsis (LONS). A total of 670 (70.5%) gram-positive cocci and 171 (19.8%) gram-negative bacilli were identified. Among the 552 coagulase-negative (CoNS) strains, the rate of oxacillin resistance was 70.6%, but no strains were resistant to linezolid, vancomycin or tigecycline. Among the antibiotic resistance patterns of the top three gram-negative pathogens, showed the highest rates of resistance, with resistance rates of 37.9% and 39.4% to ertapenem and imipenem, respectively, while and showed high levels of susceptibility to both. With regard to the trends in resistance among important pathogens, the rates of resistance to rifampicin, ciprofloxacin, levofloxacin, moxifloxacin and clindamycin by significantly decreased (p<0.05) during the study period. strains exhibited a significant increase in ceftriaxone resistance during the study period (p<0.05).
CoNS was the main microbe that caused NS, followed by . The bacterial isolates showed varying levels of resistance to the antimicrobial drugs tested. Thus, periodic surveillance in hospital settings to monitor changes in pathogens and antibiotic resistance is important.
确定引起新生儿败血症（NS）的病原体的分布及抗生素耐药模式，并评估抗生素耐药趋势。
纳入2014年至2021年间入住新生儿重症监护病房（NICU）的864例败血症患者。收集新生儿年龄、性别、致病微生物及抗菌药物敏感性数据。进行单因素和线性回归分析以确定抗生素耐药率的差异和趋势。
NS的总体发病率为每1000例活产4.59例。其中，255例（29.5%）为早发型新生儿败血症（EONS），609例（70.5%）为晚发型新生儿败血症（LONS）。共鉴定出670例（70.5%）革兰氏阳性球菌和171例（19.8%）革兰氏阴性杆菌。在552株凝固酶阴性葡萄球菌（CoNS）菌株中，苯唑西林耐药率为70.6%，但无一株对利奈唑胺、万古霉素或替加环素耐药。在前三位革兰氏阴性病原体的抗生素耐药模式中， 显示出最高的耐药率，对厄他培南和亚胺培南的耐药率分别为37.9%和39.4%，而 和 对两者均表现出高敏感性。关于重要病原体的耐药趋势，在研究期间， 对利福平、环丙沙星、左氧氟沙星、莫西沙星和克林霉素的耐药率显著下降（p<0.05）。在研究期间， 菌株对头孢曲松的耐药率显著增加（p<0.05）。
CoNS是引起NS的主要微生物，其次是 。细菌分离株对所检测的抗菌药物表现出不同程度耐药。因此，在医院环境中进行定期监测以监测病原体和抗生素耐药性的变化很重要。
