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已发表论文
早产儿医院相关性败血症病原菌分布及其十年间耐药性变化
Authors Ni SW, Wang L, Wang Y, Shen JL
Received 21 May 2025
Accepted for publication 31 August 2025
Published 23 September 2025 Volume 2025:18 Pages 5067—5077
DOI https://doi.org/10.2147/IDR.S536773
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Chi H. Lee
Shen-wang Ni,1,* Li Wang,2,* Yang Wang,2 Ji-lu Shen1
1Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, 230022, People’s Republic of China; 2Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ji-lu Shen, Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, No. 218 Jixi Road, Shushan District, Hefei, 230022, People’s Republic of China, Email shenjilu@ahmu.edu.cn
Aim: To identify the causative bacteria of healthcare-associated sepsis in preterm infants and analyze their antibiotic resistance trends over ten years, providing evidence for infection prevention strategies.
Materials and Methods: We retrospectively analyzed blood culture data from preterm infants (< 37 weeks) with healthcare-associated sepsis (onset > 72 hours after birth) admitted between January 2014 and December 2023. Pathogen distribution and antibiotic resistance patterns were compared between two periods (2014– 2018 vs 2019– 2023).
Results: Among 9928 preterm infants, 3.3% (332 cases) had positive blood cultures, with incidence increasing from 1.4% (2014– 2018) to 2.7% (2019– 2023). Gram-negative bacteria remained predominant (48.00% to 61.07%), led by Klebsiella pneumoniae. Gram-positive bacteria increased significantly (5.33% to 31.30%), primarily coagulase-negative staphylococci, while fungal infections decreased (46.67% to 7.63%). Resistance to third-generation cephalosporins persisted in K. pneumoniae (~80%) and increased in Enterobacter cloacae (60% to 90%). Emerging carbapenem resistance was observed in E. coli (0% to 33.33%) and K. pneumoniae (5.25% to 4.08%), with Enterobacter cloacae showing a significant rise (0% to 60%). ESBL-producing strains rose from 13.33% to 30.53%. All Gram-positive isolates remained susceptible to linezolid, except one vancomycin-resistant Staphylococcus capsulatus.
Conclusion: The incidence of healthcare-associated sepsis in preterm infants increased significantly, with rising carbapenem resistance in Gram-negative bacteria and a marked increase in coagulase-negative staphylococci. These trends underscore the need for enhanced infection control and judicious antibiotic use guided by blood culture results.
Keywords: sepsis, preterm infants, health care associated infections, pathogenic bacteria, drug resistance
1Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, 230022, People’s Republic of China; 2Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ji-lu Shen, Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, No. 218 Jixi Road, Shushan District, Hefei, 230022, People’s Republic of China, Email shenjilu@ahmu.edu.cn
Aim: To identify the causative bacteria of healthcare-associated sepsis in preterm infants and analyze their antibiotic resistance trends over ten years, providing evidence for infection prevention strategies.
Materials and Methods: We retrospectively analyzed blood culture data from preterm infants (< 37 weeks) with healthcare-associated sepsis (onset > 72 hours after birth) admitted between January 2014 and December 2023. Pathogen distribution and antibiotic resistance patterns were compared between two periods (2014– 2018 vs 2019– 2023).
Results: Among 9928 preterm infants, 3.3% (332 cases) had positive blood cultures, with incidence increasing from 1.4% (2014– 2018) to 2.7% (2019– 2023). Gram-negative bacteria remained predominant (48.00% to 61.07%), led by Klebsiella pneumoniae. Gram-positive bacteria increased significantly (5.33% to 31.30%), primarily coagulase-negative staphylococci, while fungal infections decreased (46.67% to 7.63%). Resistance to third-generation cephalosporins persisted in K. pneumoniae (~80%) and increased in Enterobacter cloacae (60% to 90%). Emerging carbapenem resistance was observed in E. coli (0% to 33.33%) and K. pneumoniae (5.25% to 4.08%), with Enterobacter cloacae showing a significant rise (0% to 60%). ESBL-producing strains rose from 13.33% to 30.53%. All Gram-positive isolates remained susceptible to linezolid, except one vancomycin-resistant Staphylococcus capsulatus.
Conclusion: The incidence of healthcare-associated sepsis in preterm infants increased significantly, with rising carbapenem resistance in Gram-negative bacteria and a marked increase in coagulase-negative staphylococci. These trends underscore the need for enhanced infection control and judicious antibiotic use guided by blood culture results.
Keywords: sepsis, preterm infants, health care associated infections, pathogenic bacteria, drug resistance