Journal of Clinical Pediatrics >
Pathogenic characteristics of neonatal sepsis and influence factors of gram-negative bacterial infection: based on a 5-year retrospective clinical study
Received date: 2023-07-18
Online published: 2024-03-06
Objective To investigate the distribution and drug resistance of bacteria in neonatal sepsis and to identify the influence factor for gram-negative (G-) bacterial infection. Methods The clinical data of patients diagnosed with neonatal sepsis admitted from January 1, 2018 to December 31, 2022 were collected, and the characteristics and drug resistance of major pathogenic bacteria were analyzed. Based on the pathogenic bacteria's gram staining results, all patients were categorized into groups of gram-positive (G+) and G- bacteria. The influencing factors for G- bacterial infection were analyzed by binary logistic regression, and the value of each factor was evaluated according to the area under the receiver operating characteristic curve (AUC). Results A total of 208 strains of pathogenic bacteria were detected in 201 neonatal sepsis patients, of which 126 (60.6%) were G+ bacteria and 82 (39.4%) were G- bacteria. Coagulase negative staphylococci (CoNS) was the most common G+ bacteria with high resistance to penicillin, erythromycin and oxacillin. Klebsiella pneumoniae was the most common G- bacteria with high resistance to penicillins and cephalosporins. Comparing the proportion of pathogenic bacteria in different years, it was found that the proportion of G- bacteria showed an increasing trend in the past five years. According to the results of pathogen gram staining, 201 patients were divided into G+ bacteria group (n=119) and G- bacteria group (n=82). Univariate analysis and binary logistic regression analysis showed that hospital-acquired infection, white blood cell count (WBC) < 5×109/L, C-reactive protein (CRP) and procalcitonin (PCT) were the influential factors in differentiating G- bacterial infection (P<0.05). The AUC of the combination of the above influencing factors for identifying G- bacterial infection was 0.888 (95%CI: 0.840~0.936, P<0.01). Conclusions CoNS and Klebsiella pneumoniae were the main pathogens of neonatal sepsis. The proportion of G- bacterial infection showed an increasing trend from 2018 to 2022. Hospital-acquired infection, WBC<5×109/L and higher CRP and PCT levels were risk factors for G- bacterial infection. The combination of hospital-acquired infection, WBC<5×109/L, CRP and PCT had high predictive value for G- bacterial infection.
Zhaonan BIAN , Xinyi ZHA , Xi ZHANG , Xuting CHEN , Yanru CHEN , Min XU , Yonghong ZHANG , Jihong QIAN . Pathogenic characteristics of neonatal sepsis and influence factors of gram-negative bacterial infection: based on a 5-year retrospective clinical study[J]. Journal of Clinical Pediatrics, 2024 , 42(3) : 204 -210 . DOI: 10.12372/jcp.2024.23e0661
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