Author(s)

Li Zhang^1*, Qin Zhang², Heqin Li³, Wenjing Wang⁴, Wenping Song⁵, Huirong Li⁶, Xun Jiang⁷, Liming Ni⁸, Li Liu⁹, Yaping Wang¹⁰

¹Department of Neonatology, Mother and Children’s Healthcare Hospital of Shaanxi Province, Xi’an, China.
²Department of Neonatology, People’s Hospital of Shaanxi Province, Xi’an, China.
³Department of Neonatology, Mother and Children Healthcare Hospital of Baoji City, Baoji, China.
⁴Department of Neonatology, Xi’an Children’s Hospital, Xi’an, China.
⁵Department of Neonatology, Mother and Children Healthcare Hospital of Weinan City, Weinan, China.
⁶Department of Neonatology, Yulin Children’s Hospital, Yulin, China.
⁷Department of Neonatology, Tangdu Hospital, Fourth Military Medical University, Xi’an, China.
⁸Department of Neonatology, Fourth Hospital of Xi’an City, Xi’an, China.
⁹Department of Neonatology, First Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China.
¹⁰Department of Neonatology, Xianyang First Hospital, Xianyang, China.

Objective: This study assessed the incidence, mortality, and pathogens associated with nosocomial neonatal sepsis (NNS) in Shaanxi Province to improve the prevention and control of NNS. Methods: Nine large neonatal departments in Shaanxi Province participated in this retrospective epidemiological investigation of NNS during the period of 2008-2010, using standardized protocol. The incidence, mortality, pathogens, antibiotic sensitivity, clinical characteristics, prognosis, and costs were analyzed. Results: Of 16,642 neonates admitted to neonatal departments in the 9 hospitals during 2008-2010, there were 139 cases of NNS, with incidence of 8.3% and mortality of 20.8%. The predominant pathogens were Gram-negative bacteria, accounting for 67.6% of positive cultures. Gram-positive bacteria accounted for 24.5% and fungal infection accounted for 7.9%. The most common Gram-negative species were Klebsiella pneumonia (22.3%), Escherichia coli (15.1%), and Enterobacter cloacae (8.6%). The dominant Gram-positive species identified were coagulase negative staphylococcal species (CONS) (8.6%), followed by Staphylococcus aureus (7.9%). The recovered bacterial pathogens demonstrated varying antibiotic resistance, but no meropenem-or-vancomycin-resistant strains were detected. Preterm and full-term infants showed significant difference in clinical manifestations, laboratory findings, mortality, and cost. Conclusion: NNS in the hospitals of Shaanxi Province showed a decreasing trend from 2008 to 2010, but the mortality did not reduce significantly. The predominant bacteria were Gram negative, and pathogens were found to have varying antibiotic resistance. The preterm group had higher mortality and costs than the full-term infants. Therefore, effective measures should be taken to control NNS, especially in preterm infants.

Incidence, Mortality, Pathogens, Nosocomial, Infection, Neonatal Sepsis

Zhang, L. , Zhang, Q. , Li, H. , Wang, W. , Song, W. , Li, H. , Jiang, X. , Ni, L. , Liu, L. and Wang, Y. (2016) Retrospective Epidemiological Investigation on Nosocomial Neonatal Sepsis in Shaanxi Province (2008-2010). Open Journal of Pediatrics, 6, 262-273. doi: 10.4236/ojped.2016.64037.