Retrospective study characterizes pathogens and resistance in neonates, indicating critical need for surveillance.
Objective: To characterize pathogen distribution and antimicrobial resistance among neonates with bloodstream infections at a Grade-A tertiary medical center in China. Methods: This retrospective study reviewed clinical data, culture results, and antimicrobial resistance information from neonates admitted between January 2021 and December 2024. Clinical specimens were collected in accordance with standard protocols for culture. Antimicrobial susceptibility testing was performed using an automated microbial identification system, with results interpreted according to the CLSI standards of the corresponding testing year. Results: Of 652 neonates admitted within 3 days of life, 283 had blood-culture-proven bloodstream infection; blood-culture positivity was 22.65%. Common bloodstream isolates included Staphylococcus epidermidis and Klebsiella pneumoniae . Staphylococcus epidermidis showed high resistance to penicillin, oxacillin, cefoxitin, and erythromycin, whereas Klebsiella pneumoniae was frequently resistant to cefepime and piperacillin-tazobactam. Among 290 blood-culture isolates, 161 (55.52%) were Gram-positive bacteria, including 109 MDR isolates (67.70%), and 122 (42.07%) were Gram-negative bacteria, including 32 MDR isolates (26.23%). Preterm infants, low-birth-weight infants, and late-onset bloodstream infections accounted for large proportions of the cases. Conclusion: Local surveillance of pathogen distribution and resistance patterns can support antimicrobial stewardship and infection prevention in neonatal care.
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