Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

Jidong Lai,Yao Zhu,Xinzhu Lin,Lixia Tang

doi:10.1186/s12879-021-05981-4

Abstract

BackgroundEscherichia coli (E. coli) is one of the important causative pathogens of neonatal invasive infection. The epidemiological and clinical profile of invasive E. coli infection in Chinese newborns is not well characterized.MethodsNinety-four infants with invasive E. coli infection were categorized into E. coli early onset disease (EOD) group (onset ≤72 h after birth) (n = 46) and E. coli late onset disease (LOD) group (onset > 72 h) (n = 48). We compared and analyzed the clinical characteristics and drug sensitivity profile of early-onset and late-onset E. coli invasive infection in neonates.ResultsThe incidence of E. coli-EOD and E.coli-LOD was 0.45/1000 live births (LBs) and 0.47/1000 LBs, respectively. The incidence of gestational diabetes mellitus, perinatal fever, urinary tract infection, chorioamnionitis, and positive E. coli culture among mothers in the E. coli-EOD group were significantly higher than that in E. coli-LOD group. The incidence of premature birth, low-birth-weight, nosocomial infection, and hospitalization time were significantly higher in the E. coli-LOD group. The main disease in E. coli-EOD group was pneumonia (main clinical manifestation: dyspnea). The main disease in E. coli-LOD group was sepsis (main clinical manifestation: fever). The sensitivity rates of E. coli strains to ampicillin and piperacillin were low (25.00–28.79%); sensitivity to cephalosporins was also low except ceftazidime (lowest sensitivity rate: 57.14%). Sensitivity to compound preparations containing β-lactamase inhibitors was high, even for extended spectrum β-lactamase-positive strains (nearly 100%).ConclusionE. coli is an important cause of invasive infection of newborns in Xiamen, China. E. coli-EOD was largely attributable to perinatal factors, while E. coli-LOD was largely related to nosocomial infection. Compound preparations containing β-lactamase inhibitor or carbapenem antibiotics should be preferred for neonatal invasive infection by E. coli.

Highlights

Escherichia coli (E. coli) is one of the important causative pathogens of neonatal invasive infection
We found that the incidence of neonatal E. coli-late onset disease (LOD) was associated with prematurity, low-birth-weight infants, and low breastfeeding rate; in addition, most of these cases suffered from nosocomial infection, which was consistent with a previous report [3]
Our findings suggest that E. coli is an important causative pathogen of neonatal invasive infection in Xiamen, China

Summary

Introduction

Escherichia coli (E. coli) is one of the important causative pathogens of neonatal invasive infection. Escherichia coli (E. coli) is a common causative pathogen of neonatal invasive infectious diseases [2, 3]. Neonatal E. coli-EOD is largely caused by prenatal or intrapartum infection (vertical transmission) and typically manifests as pneumonia. E. coli-LOD typically presents as sepsis, pneumonia, or meningitis, which is mostly due to environmental or nosocomial bacterial infection [2, 4]. There is considerable variability in the incidence of neonatal invasive E. coli infection in different geographical areas and countries. In an Italian study, the incidence of neonatal late-onset E. coli sepsis was found to be 0.35/1000 LBs [5]. In China, E. coli is the main causative pathogen of neonatal invasive infection, especially neonatal sepsis [6]

Objectives

Methods

Results

Discussion

Conclusion