Changing trends in the bacteriological profiles and antibiotic susceptibility in neonatal sepsis at a tertiary children’s hospital of China

BACKGROUND: Sepsis is a major cause of neonatal morbidity and mortality in developing countries, and early-onset sepsis has poor outcomes. The causative bacteria vary depending on the geographical location of the hospital. This study aimed to determine the changing trends of causative bacteria and antibiotic susceptibility in the past decade. METHODS: This study retrospectively analyzed the blood culture of positive cases of early-onset sepsis admitted to the neonatal intensive care unit of our hospital between 2009 and 2018. The cases were divided into two phases, i.e., phase I (2009 to 2013) and phase II (2014 to 2018). Changing trends in the bacteriological profiles and antibiotic susceptibility were recorded and analyzed. RESULTS: A total of 1,479 causative bacteria were detected. Gram-positive bacteria were isolated in 74.92% of the cases, and coagulase-negative Staphylococci (CoNS) (63.22%) was identified as the common isolate. Klebsiella pneumoniae (10.01%) followed by Escherichia coli (8.72%) were the dominant Gram-negative bacteria. Comparative analysis showed a significant reduction in CoNS. Among Gram-negative bacteria, K. pneumoniae was initially predominant but was replaced by E. coli in phase II. Gram-positive bacteria showed relatively high susceptibility to aminoglycosides and quinolones. K. pneumoniae exhibited higher resistance to cephalosporin compared with E. coli. Reduced sensitivity against the first- and second-generation antibiotics was observed in phase II. CONCLUSIONS: The etiological profile of neonatal sepsis (NS) has undergone a significant change in the last decade. Antibiotic resistance has increased, and continuous surveillance for antibiotic susceptibility is required to ensure efficient therapeutic outcomes.