Clinical characteristics and antibiotic resistance profile of invasive MRSA infections in newborn inpatients: a retrospective multicenter study from China

作者全名："Wu, Xia; Wang, Chuanqing; He, Leiyan; Xu, Hongmei; Jing, Chunmei; Chen, Yinghu; Deng, Jikui; Lin, Aiwei; Deng, Huiling; Cai, Huijun; Chen, Yiping; Yang, Jinhong; Zhang, Ting; Cao, Qing; Hao, Jianhua; Huang, Yuanyuan; Yu, Hui"

作者地址："[Wu, Xia; Yu, Hui] Fudan Univ, Natl Childrens Med Ctr, Dept Infect Dis, Childrens Hosp, Shanghai 201102, Peoples R China; [Wang, Chuanqing; He, Leiyan] Fudan Univ, Natl Childrens Med Ctr, Dept Clin Microbiol Lab, Childrens Hosp, Shanghai 201102, Peoples R China; [Xu, Hongmei] Chongqing Med Univ, Dept Infect Dis, Childrens Hosp, Chongqing 400014, Peoples R China; [Jing, Chunmei] Chongqing Med Univ, Dept Clin Lab, Childrens Hosp, Chongqing 400014, Peoples R China; [Chen, Yinghu] Zhejiang Univ, Dept Infect Dis, Childrens Hosp, Sch Med, Hangzhou 310052, Peoples R China; [Deng, Jikui] Shenzhen Childrens Hosp, Dept Infect Dis, Shenzhen 518038, Peoples R China; [Lin, Aiwei] Shandong Univ, Dept Infect Dis, Qilu Childrens Hosp, Jinan 250022, Peoples R China; [Deng, Huiling] Xian Childrens Hosp, Dept Infect Dis, Xian 710003, Peoples R China; [Cai, Huijun] Xian Childrens Hosp, Dept Clin Lab, Xian 710003, Peoples R China; [Chen, Yiping] Wenzhou Med Univ, Dept Pediat Infect Dis, Affiliated Hosp 2, Wenzhou 325027, Peoples R China; [Chen, Yiping; Yang, Jinhong] Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou 325027, Peoples R China; [Yang, Jinhong] Wenzhou Med Univ, Dept Clin Lab, Affiliated Hosp 2, Wenzhou 325027, Peoples R China; [Zhang, Ting] Shanghai Jiao Tong Univ, Dept Gastroenterol & Infect Dis, Childrens Hosp, Sch Med, Shanghai 200040, Peoples R China; [Cao, Qing] Shanghai Jiao Tong Univ, Dept Infect Dis, Shanghai Childrens Med Ctr, Sch Med, Shanghai 200127, Peoples R China; [Hao, Jianhua] Kaifeng Childrens Hosp, Dept Infect Dis, Kaifeng 475000, Peoples R China; [Huang, Yuanyuan] Jilin Univ, Dept Pediat, Bethune Hosp 1, Changchun 130021, Peoples R China"

通信作者："Yu, H (通讯作者)，Fudan Univ, Natl Childrens Med Ctr, Dept Infect Dis, Childrens Hosp, Shanghai 201102, Peoples R China."

来源：BMC PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000993477600001

JCR分区：Q2

影响因子：2

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Methicillin-resistant Staphylococcus aureus; Invasive infection; Clinical characteristics; Antimicrobial resistance; Neonates

摘要："BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) can cause invasive infections with significant mortality in neonates. This study aimed to analyze the clinical characteristics and antibiotic resistance profiles of invasive MRSA infections and determine risk factors associated with invasive MRSA infections in newborn inpatients.MethodsThis multicenter retrospective study of inpatients from eleven hospitals in the Infectious Diseases Surveillance of Pediatrics (ISPED) group of China was performed over a two-year period (2018-2019). Statistical significance was calculated by applying the chi 2 test or by Fisher's exact test in the case of small sample sizes.ResultsA total 220 patients were included. Among included cases, 67 (30.45%) were invasive MRSA infections, including two deaths (2.99%), while 153 (69.55%) were noninvasive infections. The invasive infections of MRSA occurred at a median age of 8 days on admission, which was significantly younger compared to 19 days in noninvasive cases. Sepsis (86.6%) was the most common invasive infection, followed by pneumonia (7.4%), bone and joint infections (3.0%), central nervous system infection (1.5%), and peritonitis (1.5%). Congenital heart disease, low birth weight infant (<2500 g), but not preterm neonates, and bronchopulmonary dysplasia, were more commonly found in invasive MRSA infections. All these isolates were susceptible to vancomycin and linezolid and were resistant to penicillin. Additionally, 69.37% were resistant to erythromycin, 57.66% to clindamycin, 7.04% to levofloxacin, 4.62% to sulfamethoxazole-trimethoprim, 4.29% to minocycline, 1.33% to gentamicin, and 3.13% were intermediate to rifampin.ConclusionLow age at admission (<= 8 days), congenital heart disease, and low birth weight were associated with invasive MRSA infections in neonates, and no isolates resistant to vancomycin and linezolid were found. Determining these risks in suspected neonates may help identify patients with imminent invasive infections who may require intensive monitoring and therapy."

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