Emerging Threat of Multidrug Resistant Pathogens From Neonatal Sepsis

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Neonatology

Background:

• Neonatal sepsis poses a significant global health challenge, particularly due to multidrug-resistant (MDR) pathogens.
• Limited characterization of MDR pathogens causing neonatal sepsis in China necessitates further investigation.

Purpose of the Study:

• To identify and characterize bacterial pathogens and their antimicrobial resistance patterns in hospitalized neonates with sepsis in Southwest China.
• To determine the prevalence of MDR pathogens in early-onset sepsis (EOS) and late-onset sepsis (LOS) and identify associated risk factors.

Main Methods:

• A retrospective analysis of 240 bacterial isolates from neonates with sepsis across four hospitals in Southwest China (2014-2019).
• Identification of pathogens, antimicrobial susceptibility testing, and detection of key resistance genes (e.g., blaCTX-M, NDM-1).
• Statistical analysis to identify factors associated with MDR infections.

Main Results:

• Gram-negative bacteria (53.75%) predominated, with Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) being the most common pathogens.
• MDR pathogens were prevalent in both EOS (64.86%) and LOS (78.33%), with E. coli and K. pneumoniae being major contributors.
• blaCTX-M, particularly blaCTX-M-15, was the dominant resistance gene; all carbapenem-resistant K. pneumoniae harbored NDM-1.
• Late-onset sepsis and prior antibiotic exposure were significantly associated with MDR infections.

Conclusions:

• Multidrug-resistant pathogens, especially E. coli and K. pneumoniae, represent a critical threat to neonates in Southwest China.
• The high prevalence of MDR pathogens and specific resistance genes underscores the need for enhanced infection control and antimicrobial stewardship.
• Findings highlight regional variations in pathogen prevalence compared to other areas, emphasizing the need for localized strategies.