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Updated: Jun 6, 2025
Non-Invasive Model of Neuropathogenic Escherichia coli Infection in the Neonatal Rat
Published on: October 29, 2014
Pathogen Distribution of Neonatal Bacterial Meningitis in the Era of Multidrug-Resistant Bacteria: A Single-Center
Minli Zhu1, Jing Lin2, Zhangming Zhuge1
1Key Laboratory of Perinatal Medicine of Wenzhou, Department of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, People's Republic of China.
Purpose:
Neonatal bacterial meningitis (NBM) is a serious disease with high morbidity and mortality. This study aimed to establish a foundation for the selection of empirical antibiotics for NBM through an analysis of pathogen distribution and shift in antimicrobial resistant pattern.
Patients And Methods:
A retrospective cohort study on culture confirmed NBM from 2005 to 2022.
Results:
A total of 191 cases were enrolled, 48 for premature infants and 70 for early-onset meningitis. The incidence of NBM in first half and last half period was 0.2‰ and 0.24‰, while the mortality was 12.0% and 5.6% respectively. The top two pathogens were Escherichia coli (E. coli) (40.3%) and Group B Streptococcus (GBS) (29.8%). E. coli was the most common pathogen in both periods, Enterococcus (13.3% vs 0.9%, P < 0.05) and Staphylococcus aureus (8.4% vs 1.9%, P < 0.05) decreased, while GBS increased significantly in the periods [16.9% vs 39.8%, P < 0.001]. Gram-positive bacteria were more common in full term infants (53.8% vs 27.1%, P = 0.001), while gram-negative bacteria were more common in preterm infants (72.9% vs 46.2%, P = 0.001). All isolated GBS strains were susceptible to penicillin. On the other hand, less than 60% of E. coli were susceptible to third generation of cephalosporins, and were only susceptible to carbapenem or amikacin. This was mainly due to production of extended-spectrum beta-lactamase (ESBLs) which was higher in late-onset group than that in early-onset group (45.1% vs 19.2%, P = 0.026).
Conclusion:
Incidence of NBM has not changed significantly over the last 2 decades. E. coli remains as the most common pathogen of NBM despite that GBS has increased in recent 9 years, especially in full-term infants. While all isolated GBS are susceptible to penicillin, over a third of E. coli strains are multidrug resistant due to production of ESBLs.
