AUTHOR=Zou Hua , Jia Xiaojiong , He Xiao , Su Yan , Zhou Ligang , Shen Yan , Sheng Chenglin , Liao Ang , Li Chunli , Li Qiuhong 

TITLE=Emerging Threat of Multidrug Resistant Pathogens From Neonatal Sepsis

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.694093

DOI=10.3389/fcimb.2021.694093

ISSN=2235-2988

ABSTRACT=<p>Multidrug-resistant (MDR) pathogens are responsible for a substantial burden of morbidity and mortality from neonatal sepsis; however, data on these sepsis-related pathogens among hospitalized neonates in China are not well characterized. In this study, a total of 240 strains were isolated from four Women and Children’s hospitals in Southwest China between 2014 and 2019. Of these included pathogens, 104 (43.33%) were gram-positive bacteria, 129 (53.75%) were gram-negative bacteria, and 7 (2.92%) were fungi. <italic>Escherichia coli</italic> (<italic>E. coli</italic>, 34.01%) and <italic>Klebsiella pneumoniae</italic> (<italic>K. pneumoniae</italic>, 15.35%) were the main pathogen of neonate bacteremia. ST167 were the most prevalent STs in <italic>E. coli</italic> and ST11 in <italic>K. pneumoniae.</italic> Our study found that <italic>E. coli</italic> (62.71%) was the predominate pathogen of early-onset sepsis, among which 64.86% were MDR. Late-onset sepsis was mainly caused by <italic>K. pneumoniae</italic> (28.31%) and <italic>E. coli</italic> (24.78%), with showing that 78.33% of these pathogens were MDR. Notably, the prevalence of EO/LO pathogens were quite different from Indian and south of China. Moreover, we found that <italic>bla</italic><sub>CTX-M</sub> (42.06%) was most dominant resistant genes with about a third isolates (31.09%) were positive for <italic>bla</italic><sub>CTX-M-15</sub>. All the carbapenem-resistant <italic>K. pneumoniae</italic> were positive for NDM-1. Moreover, late-onset sepsis and antibiotic exposure were significantly associated with MDR infection. Emerging multi-resistant pathogens of sepsis posts a serious threat to neonatal outcomes and emphasizes an urgent need to control their further spread.</p>