Clinical characteristics and drug resistance of hospital-acquired Escherichia coli bloodstream infection in neonates

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Objective To analyze the clinical features and bacterial drug resistance of hospital-acquired Escherichia coli (E.coli) bloodstream infection in neonates. Methods From 2016 to 2017, 23 inpatients with hospital-acquired E.coli bloodstream infection from Shenzhen University Maternal and Child Health Hospital and Gaozhou People’s Hospital were studied. The basic disease, clinical characteristics, antibiotic resistance, outcomes and hospital costs were analyzed. Results Among the 23 cases, the most common symptom was fever (20 cases) , followed by an elevating of blood glucose (>7 mmol/L, 10 cases) . There were 18 cases of respiratory system damage, including 10 cases of respiratory failure requiring ventilator-assisted ventilation and 2 cases of pulmonary hemorrhage. Circulatory system damages were found in 5 cases. A total of 10 ESBLs-positive E. coli strains were checked out, and more than 80% of which were resistant to ampicillin, ceftriaxone, cefepime, cefazolin, aztreonam and compound sulfamethoxazole. The resistant rates were all higher than those of ESBLs-negative E.coli strains (P<0.05) . The hospitalization cost of ESBLs-positive strain infected neonates was higher than that of the ESBLs-negative strains [ (2.26±0.91) ×104 yuan vs (1.68±0.83) ×104 yuan, t=4.62, P<0.01]. Conclusions Fever and respiratory signs can be considered as early indications of hospital-acquired E.coli bloodstream infection in neonates. The resistant rate of ESBLs-positive E. coli strains is high, and the treament costs more. Key words: Infant; Nosocomial infection; Escherichia coli; Septicemia