Antibiotic resistance in neonates in China 2012-2019：a multicenter study

Abstract Background To investigate antibiotic resistance of pathogens responsible for neonatal invasive bacterial infections(IBIs) in China. Methods Cross-sectional study of neonates with IBI evaluated in nine hospitals in China (January 2012 - August 2019). Antibiotic resistance patterns of pathogens responsible for neonatal IBIs were analyzed. Results Of 3770 full-term neonates who were subjected to lumbar puncture and a blood culture, IBIs were diagnosed in 460 neonates (12.2%). Escherichia coli and Group B Streptococcus (GBS) were the leading pathogens, followed by Enterococcus spp, and Staphylococcus aureus. Escherichia coli expressed high resistance to ampicillin (72.0%) and third-generation cephalosporins (cefotaxime, 34.8%; ceftriaxone, 38.1%). The prevalence of extended spectrum beta-lactamase (ESBL)-producing Escherichia coli was 34.1%. The proportions of Enterococcus spp resistant to penicillin and ampicillin were 60% and 54.1%. All Staphylococcus aureus showed resistance to ampicillin and penicillin. The resistance rate of Staphylococcus aureus to methicillin was 50%. Although all GBS were susceptible to penicillin and ampicillin, the proportions of GBS resistant to erythromycin and clindamycin were 75.9% and 77.3%. Antibiotic susceptibility appeared to improve in 2019. Susceptibility of Escherichia coli to ampicillin, cefotaxime, and ceftriaxone improved to 42.9%, 76.9%, and 71.4% in 2019, compared with 12.5%, 37.5%, and 50% in 2012. The prevalence of ESBL-producing Escherichia coli declined to 20% in 2019, lower than 100% in 2012. Susceptibility of GBS to erythromycin and clindamycin improved from 0% in 2012 to 28.6% and 25% in 2019. Conclusions The prevalence of antibiotic resistance is high in neonates in China, although there is a favorable declining trend in recent years.