Wu Ruixue, Cui Xiaoyu, Pan Rui, Li Na, Zhang Ying, Shu Jianbo, Liu Yang
Graduate College, Tianjin Medical University, Tianjin, China.
Neonatal Department of Longyan Division, Tianjin Children's Hospital, Tianjin University Children's Hospital, Tianjin, China.
Eur J Clin Microbiol Infect Dis. 2025 Apr;44(4):779-788. doi: 10.1007/s10096-025-05048-1. Epub 2025 Jan 24.
Neonatal sepsis is one of the causes of neonatal mortality and bacterial resistance to antibiotics is one of the challenges facing NICU. The aim of this study was to provide a basis for empirical antibiotic selection by comprehensively searching Chinese and non-Chinese databases for studies related to neonatal sepsis pathogenesis conducted in China and synthesizing all the results of the studies conducted in hospitals in China during the period under study METHODS: In this study, we conducted extensive searches of Pubmed, Web of Science, Cochrane, China Biology Medicine disc (SinoMed), China National Knowledge Infrastructure (CNKI) and Wanfang Data. We screened studies published from 2014 to 2023 that were conducted in hospitals in mainland China and involved bacterial blood cultures and susceptibility tests in neonates with neonatal sepsis and extracted the data, which were summarized using Stata 18.0 software to determine the bacterial characteristics of NS and its antimicrobial resistance in China.
A total of 97 articles were finally included in the study, involving 27 provinces, municipalities and autonomous regions, and a total of 18,796 bacterial strains were isolated. Among them, Gram-positive bacteria (G+) accounted for 63.4% (95% CI 59.6%67.3% ), and Gram-negative bacteria (G-) accounted for 36.6% (95% CI 32.7%40.4%). The most common bacteria were, in order, Coagulase-negative Staphylococcus (43.6%, 95% CI 37.9-49.3%), Enterobacter (16.4%, 95% CI 14.8-18.1%), and Klebsiella (12.4%, 95% CI 10.8-14.0%). More than 80% of G + were resistant to penicillin, ampicillin, and benzathine, and no strains resistant to minocycline or daptomycin were found. More than 80% of G- were resistant to benzoxicillin, ampicillin, and cefotaxime, and no strains resistant to vancomycin, clindamycin, tigecycline, teicoplanin, and linezolid were identified.
Coagulase-negative Staphylococcus is still the main causative agent for children with neonatal sepsis in China, followed by Enterobacter and Klebsiella. In addition, Group B Streptococcus is no longer in the top three common causative agents. Resistance to penicillin antibiotics is evident among the causative organisms of neonatal sepsis in China.
新生儿败血症是新生儿死亡的原因之一，细菌对抗生素的耐药性是新生儿重症监护病房面临的挑战之一。本研究的目的是通过全面检索中文和非中文数据库，查找在中国进行的与新生儿败血症发病机制相关的研究，并综合研究期间在中国医院进行的所有研究结果，为经验性抗生素选择提供依据。方法：在本研究中，我们广泛检索了PubMed、Web of Science、Cochrane、中国生物医学文献数据库（SinoMed）、中国知网（CNKI）和万方数据。我们筛选了2014年至2023年在中国大陆医院发表的、涉及新生儿败血症新生儿细菌血培养和药敏试验的研究，并提取数据，使用Stata 18.0软件进行汇总，以确定中国新生儿败血症的细菌特征及其抗菌耐药性。
本研究最终纳入97篇文章，涉及27个省、直辖市和自治区，共分离出18796株细菌。其中，革兰氏阳性菌（G+）占63.4%（95%CI 59.6%67.3%），革兰氏阴性菌（G-）占36.6%（95%CI 32.7%40.4%）。最常见的细菌依次为凝固酶阴性葡萄球菌（43.6%，95%CI 37.9 - 49.3%）、肠杆菌（16.4%，95%CI 14.8 - 18.1%）和克雷伯菌（12.4%，95%CI 10.8 - 14.0%）。超过80%的G+对青霉素、氨苄西林和苄星青霉素耐药，未发现对米诺环素或达托霉素耐药的菌株。超过80%的G-对苯唑西林、氨苄西林和头孢噻肟耐药，未发现对万古霉素、克林霉素、替加环素、替考拉宁和利奈唑胺耐药的菌株。
凝固酶阴性葡萄球菌仍是中国新生儿败血症患儿的主要致病菌，其次是肠杆菌和克雷伯菌。此外，B族链球菌不再是三大常见致病菌之一。中国新生儿败血症致病菌对青霉素类抗生素耐药明显。
