<p>Incidence, Bacterial Profiles, And Antimicrobial Resistance Of Culture-Proven Neonatal Sepsis In South China</p>

Abstract

BackgroundNeonatal sepsis (NS) is one of the leading causes of infant morbidity and mortality, but little is known about pathogen incidence and distribution in China.MethodsIn this retrospective study (January 2012 to December 2016), culture-proven cases aged less than 28 days with diagnosed NS in the Guangzhou Women and Children’s Medical Center, South China, were analyzed for pathogen incidence and antimicrobial resistance.ResultsA total of 620 isolates were identified from 597 NS cases. Gram-negative bacteria (n=371, 59.8%) dominated over Gram-positive bacteria (n=218, 35.2%) and fungi (n=30, 4.8%). Klebsiella pneumoniae (21.9%), Escherichia coli (21.9%), group B Streptococcus (GBS, 13.2%), and Staphylococcus aureus (6.8%) were the four most predominant pathogens. In early-onset sepsis (EOS), GBS (30.0%) and E. coli (20.0%) were dominant, whereas in late-onset sepsis (LOS), K. pneumoniae (25.6%) and E. coli (22.4%) were dominant. E. coli (25.2%) and GBS (17.7%) were the most frequently isolated from term patients, whereas K. pneumoniae was the most frequently isolated from preterm patients (34.9%). Of the infected infants, 9.5% died from sepsis, most commonly by E. coli infection (16.2%). Among 91,215 live births (LBs) delivered in the study hospital (2012–2016), 252 infants developed sepsis infection (2.76 per 1000 LBs, 95% CI 2.4–3.1), including EOS (0.78 per 1000 LBs) and LOS (2.13 per 1000 LBs). All GBS isolates were susceptible to β-lactam antibiotics, and S. aureus, including methicillin-resistant isolates, were susceptible to vancomycin. An extended-spectrum β-lactamase producer was identified in 37.3% of E. coli and 50.4% of K. pneumoniae.ConclusionK. pneumoniae was the most frequent pathogen in culture-proven NS in South China, primarily associated with LOS in preterm, whereas GBS was the dominant pathogen in EOS. E. coli was common in both episodes with the highest mortality.

Pathogens Distribution and Antimicrobial Resistance of Bloodstream Infections at Twenty-Five NICUs in Eastern China, 2016-2019

“…E coli was an important GNP in low-income settings and was the second most common early-onset BSI pathogen in a large US prospective cohort study (17). Similar to recent reports from Chinese and other Asian counties, GNP predominated in the pathogens causing EOS in our study, with the top one E. coli responsible for 27.2% (17,22,23). GBS was second common pathogen of EOS accounting for 14.6%.…”

“…We found that K pneumonia was the most frequently pathogen with hospital-acquired LOS, followed by E. coli, which is parallel with the results of a latest study in south China (23). Meanwhile, CoNS was the third common pathogen causing LOS accounting for 11.2%, with majority of identi ed from VLBW.…”

Pathogens Distribution and Antimicrobial Resistance in Bloodstream Infections in Twenty-Five Neonatal Intensive Care Units in China, 2017-2019

“…In current study, about two thirds of pathogens identi ed were responsible for HALOS. Approximately 60% of HALOS were due to GNB which was similar to the results from previous Chinese studies (21,22). A review of 11,471 bloodstream samples indicated that GNB was detected from no less than 60% of positive blood cultures in all the developing settings of the world (23).…”

“…Another remarkable nding in the Chinese NICUs was the relatively high percentage of fungi in HALOS. Nearly all the identi ed fungi infections were responsible for HALOS, which was paralleled with other Chinese studies (21,22). Similarly, recent studies have also reported outbreaks of fungal nosocomial infection in Chinese NICUs which alerted clinicians (26,27).…”

Pathogens distribution and antimicrobial resistance in bloodstream infections in twenty-five neonatal intensive care units in China, 2017–2019

“…A previous meta-analysis reported that Staphylococcus species, especially Coagulase negative Staphylococcus ( CoNS ) continue to be the principal organisms of neonatal sepsis in China [ 10 ]. Nevertheless, more recent data described Klebsiella pneumoniae as the most frequent pathogen, with widespread antimicrobial resistance (AMR) [ 11 ]. Klebsiella pneumoniae was primarily associated with LOS, greater morbidity, mortality and limited treatment options in neonates [ 11 , 12 ].…”