Multidrug-resistant Gram-negative bacilli in neonatal intensive care unit in South China

Abstract

Background Multidrug-resistant (MDR) gram-negative bacilli (MDR-GNB) infections have become a public health issue with time, especially, because of antibiotic abuse now. This study was aimed at elucidating the situation and clinical characteristics of MDR-GNB infectionsof a representative neonatal intensive care units (NICUs) in China.Methods Patients infected with MDR-GNB were collected between January 2017 and May 2022 in our hospital. Patient data on sex, premature delivery, gestational age, high-risk factors before delivery, delivery mode, invasive operation, premature rupture of membranes, routine blood test results, and outcomes were collected.Results Four hundred and twenty-five MDR-GNB were found in 242 patients. Escherichia coli and Klebsiella pneumoniae were the most commonly detected organisms (78.4% and 15.3%, respectively). Two hundred and seventeen extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae were detected. Only 11 cases (2.6%) of infection with carbapenem-resistant Enterobacteriaceae (CRE) were detected in 2 patients, and nine were Klebsiella pneumoniae, two were Escherichia coli. Among these 242 patients, 131 (54.1%) and 111(45.9%) patients showed colonization and infection, respectively. Sixty-seven patients had sepsis, and 55 of these patients developed sepsis due to infection with MDR-GNB. Birth weight < 1500 g was the risk factor for infection (p = 0.006, OR 3.338, 95%CI 1.418–7.858). And whose mothers had fever before delivery (p = 0.022, OR 2.679, 95%CI 1.153–6.221) and the birth weight less than 1500g (p = 0.029, OR 2.768, 95%CI 1.107–6.918) were the risk factors for sepsis.Conclusions Escherichia coli and Klebsiella pneumoniae were the most common MDR-GNB detected in NICU patients. Low birth weight and mothers had fever before delivery were the risk factors for sepsis to patients with MDR-GNB in NICU.