Change in pathogens and antimicrobial resistance in neonatal septicemia during 6 years / 中国感染控制杂志

ABSTRACT

Objective To understand the pathogens causing neonatal septicemia,as well as changing trend of anti-microbial resistance,and provide evidence for clinical anti-infection treatment.Methods Results of blood culture and antimicrobial susceptibility testing of pathogens from neonates with septicemia who were admitted to the depart-ment of neonatology of a hospital from January 2009 to December 2014 were analyzed retrospectively,distribution of pathogens and antimicrobial resistance between 2009 -2011 and 2012 -2014 were compared.Results A total of 259 strains were isolated from blood specimens,gram-positive bacteria,gram-negative bacteria,and fungi were 175 (67.57%),65 (25.10%),and 19 (7.33%)respectively.Coagulase-negative staphylococcus (CNS)was the main pathogen during 6 years,followed by Klebsiella pneumoniae (K .pneumoniae);the constituent ratio of the extend-ed-spectrumβ-lactamase (ESBLs)-producing strains increased from 10.56% to 15.38%,constituent ratio of fungi increased from 4.93% to 10.25%(P >0.05);The sensitivity of gram-positive bacteria to vancomycin,teicoplanin, and linezolid were all 100.00%,82.28%-88.33% of CNS and 75.00%-100.00% of Staphylococcus aureus were methicillin-resistant;the resistance rates of K .pneumoniae and Escherichia coli to the third-generation cephalospo-rins were 42.86% - 86.67%,to cefoperazone/sulbactam increased from 17.39% and 14.29% to 33.33% and 30.00% respectively,meropenem-and imipenem-resistant strains were not found.Resistance rate of Candida albi-can to fluconazole increased from 20.00% to 50.00%,all detected fungi remained sensitive to amphotericin B. Conclusion CNS are the major pathogens in neonatal septicemia,followed by K .pneumoniae ,constituent ratio of fungal infection has increased.Antimicrobial agents should be chosen according to blood culture and antimicrobial susceptibility testing results.