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Background <p>Multidrug-resistant (MDR) Gram-negative bacilli (MDR-GNB) infections have emerged as a public health concern. This study investigated the clinical characteristics and risk factors of MDR-GNB infections in a representative neonatal intensive care unit (NICU) in China.</p> Methods <p>Data on neonates with positive MDR-GNB cultures between January 2017 and May 2022 at one hospital were collected. Neonate information, including 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.</p> Results <p>A total of 425 MDR-GNB isolates were detected among 242 neonates. <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> were the predominant organisms identified, accounting for 78.4% and 15.3% of the 425 isolates, respectively. In addition, 217 isolates of extended-spectrum beta-lactamase (ESBL)-producing <i>Enterobacterales</i> were identified. Among the 242 neonates, 131 (54.1%) exhibited colonization, while 111 (45.9%) had active infections. Sixty-seven neonates had sepsis, and 55 of these developed sepsis due to infection with MDR-GNB. Low birth weight (&lt; 1500&#xa0;g) was identified as a significant risk factor for infection (<i>p</i> = 0.006, OR: 3.338, 95%CI: 1.418–7.858). Maternal fever before delivery (<i>p</i> = 0.022, OR 2.679, 95%CI 1.153–6.221) and low birth weight (&lt; 1500&#xa0;g) (<i>p</i> = 0.029, OR: 2.768, 95%CI: 1.107–6.918) were risk factors for sepsis.</p> Conclusions <p><i>E. coli</i> and <i>K. pneumoniae</i> were the predominant MDR-GNB strains detected in neonates in the NICU. Low birth weight and maternal fever before delivery were risk factors for sepsis among NICU patients with MDR-GNB infections.</p> Clinical trial number <p>Not applicable.</p>

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Risk factors for neonatal multidrug-resistant Gram-negative bacilli infection in a neonatal intensive care unit in South China: a 5-year clinical analysis

  • 期刊论文

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  • 发表日期：

    2026年5月22日

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  • Powei Tang,
  • Xiaohong Chen,
  • Fei Xiao,
  • Yilin Hu,
  • Jindou Hao,
  • Jia Tian,
  • Wanqu Liu,
  • Yu Zhang,
  • Peihui Liu

摘要

Background

Multidrug-resistant (MDR) Gram-negative bacilli (MDR-GNB) infections have emerged as a public health concern. This study investigated the clinical characteristics and risk factors of MDR-GNB infections in a representative neonatal intensive care unit (NICU) in China.

Methods

Data on neonates with positive MDR-GNB cultures between January 2017 and May 2022 at one hospital were collected. Neonate information, including 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

A total of 425 MDR-GNB isolates were detected among 242 neonates. Escherichia coli and Klebsiella pneumoniae were the predominant organisms identified, accounting for 78.4% and 15.3% of the 425 isolates, respectively. In addition, 217 isolates of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales were identified. Among the 242 neonates, 131 (54.1%) exhibited colonization, while 111 (45.9%) had active infections. Sixty-seven neonates had sepsis, and 55 of these developed sepsis due to infection with MDR-GNB. Low birth weight (< 1500 g) was identified as a significant risk factor for infection (p = 0.006, OR: 3.338, 95%CI: 1.418–7.858). Maternal fever before delivery (p = 0.022, OR 2.679, 95%CI 1.153–6.221) and low birth weight (< 1500 g) (p = 0.029, OR: 2.768, 95%CI: 1.107–6.918) were risk factors for sepsis.

Conclusions

E. coli and K. pneumoniae were the predominant MDR-GNB strains detected in neonates in the NICU. Low birth weight and maternal fever before delivery were risk factors for sepsis among NICU patients with MDR-GNB infections.

Clinical trial number

Not applicable.