Clinical Characteristic and Pathogen Spectrum of Neonatal Sepsis in Guangzhou City from June 2011 to June 2017

Abstract

Background Preterm and low birth weight (birth weight <2500 g) neonates are vulnerable to sepsis, and the causative pathogens vary in different regions and times. The objective of this study was to identify common organisms leading to neonatal sepsis and identify the characteristic of patients infected with different bacteria, which may help in the selection of antibiotics for empirical treatment. Material/Methods We retrospectively collected the clinical and microbiological data of neonates with culture-proven sepsis in our clinical setting from June 2011 to June 2017. The demography, composition, and distribution of the pathogens and the clinical characteristic of the cases infected with different bacteria were analyzed. Results Of a total of 1048 bacteria that were isolated from patient samples, detailed clinical and microbiological data of 297 cases were available. Escherichia coli , Klebsiella pneumoniae , and coagulase-negative Staphylococcus (co-NS) were the top 3 isolated pathogens . Streptococcus agalactiae predominantly led to early-onset sepsis, while K. pneumoniae and Staphylococcus aureus mainly led to late-onset sepsis. K. pneumoniae was mainly acquired in the hospital. Leukopenia was more commonly seen than leukocytosis in our study, and patients infected with K. pneumoniae and Candida spp encountered more thrombocytopenia. Conclusions The results of our study revealed the composition of the pathogens of neonatal sepsis in our region and the clinical characteristic of sepsis caused by different bacteria; these data may help in the selection of antibiotics for empirical treatment of neonates with high risk of sepsis.

Late-onset neonatal sepsis in Suzhou, China

“…In some regions from developing countries, CoNS have been reported to play a less important role [22,23]. In China, Guo et al found that CoNS was the third common organism responsible for LOS in South China [24], while Li et al found that CoNS was the most common organism in Southeast China [25]. The results in our study are in line with Guo's study.…”

“…infection were preterm low birth weight infants. The fungi infection rate in our study is similar to the results of Guo's study [24], but significantly higher than the results of 2 other studies conducted in other regions of China [13,14].…”

“…Other Gram-negative bacilli were recovered but in a few numbers. The predominance of E. coli and K. pneumoniae among the causative Gram-negative pathogens was also reported in other studies in China and other different countries [24,27]. In contrast,…”

A retrospective analysis of pathogen profile, antimicrobial resistance and mortality in neonatal hospital-acquired bloodstream infections from 2009–2018 at Tygerberg Hospital, South Africa

“…S . marcescens remains an important pathogen in our neonatal unit and is associated with mortality and severe neurological impairment [ 32 , 33 ], a finding which has not yet been described in other LMIC settings [ 25 , 32 , 34 – 39 ]. A .…”

“…aureus and Enterococcus species were responsible for most HA-BSI episodes due to Gram-positive pathogens, and these remain associated with significantly lower mortality than Gram-negative and fungal BSI pathogens [ 11 ]. Pathogen spectrum varies geographically, with most centres reporting a predominance of coagulase-negative staphylococci [ 25 , 26 , 31 , 39 , 42 , 43 ]. Coagulase-negative staphylococci were defined as pathogens in this context using a strict definition, likely resulting in underestimation of their contribution to overall HA-BSI in this study.…”