To investigate the characteristics of distribution and drug resistance of bacterial infection in neonates from 2020 to 2022 in Xi’an Children’s Hospital.

The specimens were collected from hospitalized neonates from January 2020 to December 2022 in Xi’an Children’s Hospital, and the distribution, composition and drug resistance of the specimens were analyzed, which were compared with the national children surveillance data by Pearson Chi-square test.

Total of 496 strains of bacteria were isolated from 9 346 specimens; including 251 (50.60%) strains of Gram-negative bacteria and 231 (46.57%) strains of Gram-positive bacteria; 14 (2.83%) strains of fungi. The top-five bacteria were Escherichia coli (Eco) (90 strains, 18.15%), Coagulase negative Staphylococci (CNS) (71 strains, 14.31%), Klebsiella peneumoniae (Kpn) (69 strains, 13.91%), Staphylococcus aureus (Sau) (57 strains, 11.49%) and Enterococcus faecium (Efa) (41 strains, 8.27%). Total of 184 strains of multi-drug resistant bacteria were detected from 496 pathogenic bacteria (37.09%); 105 (57.07%) strains of Gram-negative bacteria and 79 (42.93%) strains of Gram-positive bacteria were detected among multiple drug resistant bacteria. The detection rates of Kpn, CNS, Sau, Eco, AB and Pa were 58 strains (84.06%), 56 strains (78.87%), 23 strains (40.35%), 36 strains (40.00%), 4 strains (36.36%) and 7 strains (33.33%). The strains were highly resistant to many kinds of antibiotics, some drug resistance rates were significantly different from the national surveillance levels. The resistance rate of CNS (97.2%) to penicillin were significantly higher than those of Sau (94.7%). The resistance rate of Sau and CNS against clindamycin were 68.4% and 59.2%, which were significantly higher than those of the national surveillance levels (36.7% and 42.3%) (χ² = 24.431, P < 0.001; χ² = 8.119, P = 0.004). The resistance rates of Eco to cephalosporins were different as the follows: 75.5% to cefazolin, 67.8% to cefuroxime, 65.5% to cefatriaxone, which were significantly higher than those of the national surveillance levels (58.8%, 47.5% and 46.6%) (χ² = 10.329, P = 0.001; χ² = 14.674, P < 0.001; χ² = 12.841, P < 0.001). The resistance rates of Kpn to cephalosporins were as the follows: 76.81% to cefatriaxone, 68.1% to Cefazolin, 62.8% to ceftazidime, 62.3% to cefuroxime, which were significantly higher than those of the national surveillance levels (44.1%, 53.2%, 30.6% and 49.0%), with significant differences (χ² = 29.240, P < 0.001; χ² = 6.056, P = 0.014, χ² = 34.583, P < 0.001; χ² = 4.789, P = 0.029). The resistance rates to meropenem and imipenem were 39.1% and 40.6%, respectively, significantly higher than 14.8% and 11.7% of the national monitoring data, with significant differences (χ² = 30.816, P < 0.001; χ² = 52.243, P < 0.001).

The majority of hospitalized neonatal pathogens from 2020 to 2022 in our hospital were CNS, Eco and Kpn. The drug resistance rates of Sau and CNS to clindamycin; Eco to cefazolin, cefuroxime, and ceftriaxone, and Kpn to cephalosporins and carbapenems were significantly higher than the national surveillance data. Antibiotics should be used rationally according to the distribution of main pathogenic bacteria locally and the results of drug sensitivity.