ArticleBMC pediatrics2026
Risk factors for neonatal multidrug-resistant Gram-negative bacilli infection in a neonatal intensive care unit in South China: a 5-year clinical analysis.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMultidrug-resistant (MDR) Gram-negative bacilli (MDR-GNB) infections have emerged as a public health concern. This study investigated the clinical characteristics and risk factors of MDR-GNB infections in a representative neonatal intensive care unit (NICU) in China.
methodsData on neonates with positive MDR-GNB cultures between January 2017 and May 2022 at one hospital were collected. Neonate information, including sex, premature delivery, gestational age, high-risk factors before delivery, delivery mode, invasive operation, premature rupture of membranes, routine blood test results, and outcomes, were collected.
resultsA total of 425 MDR-GNB isolates were detected among 242 neonates. Escherichia coli and Klebsiella pneumoniae were the predominant organisms identified, accounting for 78.4% and 15.3% of the 425 isolates, respectively. In addition, 217 isolates of extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales were identified. Among the 242 neonates, 131 (54.1%) exhibited colonization, while 111 (45.9%) had active infections. Sixty-seven neonates had sepsis, and 55 of these developed sepsis due to infection with MDR-GNB. Low birth weight (< 1500 g) was identified as a significant risk factor for infection (p = 0.006, OR: 3.338, 95%CI: 1.418-7.858). Maternal fever before delivery (p = 0.022, OR 2.679, 95%CI 1.153-6.221) and low birth weight (< 1500 g) (p = 0.029, OR: 2.768, 95%CI: 1.107-6.918) were risk factors for sepsis.
conclusionsE. coli and K. pneumoniae were the predominant MDR-GNB strains detected in neonates in the NICU. Low birth weight and maternal fever before delivery were risk factors for sepsis among NICU patients with MDR-GNB infections. CLINICAL TRIAL NUMBER: Not applicable.
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