Journal of Microbiology, Immunology and Infection ( IF 4.5 ) Pub Date : 2021-05-15 , DOI: 10.1016/j.jmii.2021.05.004 Jintong Tan 1 , Yiwen Wang 1 , Xiaohui Gong 2 , Jing Li 3 , Wenhua Zhong 4 , Liqin Shan 4 , Xiaoping Lei 5 , Qian Zhang 6 , Qin Zhou 7 , Youyan Zhao 8 , Chao Chen 9 , Yongjun Zhang 1
Background
To investigate antibiotic resistance of pathogens responsible for neonatal invasive bacterial infections (IBIs) in China.
Methods
Cross-sectional study of neonates with IBI evaluated in nine hospitals in China (January 2012–August 2019). Antibiotic resistance patterns of pathogens responsible for neonatal IBIs were analyzed.
Results
Of 3770 full-term neonates who were subjected to lumbar puncture and a blood culture, IBIs were diagnosed in 460 neonates (12.2%). Escherichia coli and Group B Streptococcus (GBS) were the leading pathogens, followed by Enterococcus spp, and Staphylococcus aureus. E. coli expressed high resistance to ampicillin (72.0%) and third-generation cephalosporins (cefotaxime, 34.8%; ceftriaxone, 38.1%). The prevalence of extended spectrum beta-lactamase (ESBL)-producing E. coli was 34.1%. The proportions of E. spp resistant to penicillin and ampicillin were 60% and 54.1%. All S. aureus showed resistance to ampicillin and penicillin. The resistance rate of S. aureus to methicillin was 50%. Although all GBS were susceptible to penicillin and ampicillin, the proportions of GBS resistant to erythromycin and clindamycin were 75.9% and 77.3%. Antibiotic susceptibility appeared to improve in 2019. Susceptibility of E. coli to ampicillin, cefotaxime, and ceftriaxone improved to 42.9%, 76.9%, and 71.4% in 2019, compared with 12.5%, 37.5%, and 50% in 2012. The prevalence of ESBL-producing E. coli declined to 20% in 2019, lower than 100% in 2012. Susceptibility of GBS to erythromycin and clindamycin improved from 0% in 2012 to 28.6% and 25% in 2019.
Conclusions
The prevalence of antibiotic resistance is high in neonates in China, although there is a favorable declining trend in recent years.