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Drug resistance characteristics and molecular typing of Escherichia coli isolates from neonates in class A tertiary hospitals: A multicentre study across China

  • Author Footnotes
    1 These authors contributed equally to this work.
    Song Gu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neonatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Jidong Lai
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China

    Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, Fujian, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Wenqing Kang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Neonatal Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan, China

    Zhengzhou Key Laboratory of Neonatal Disease Research, Zhengzhou, Henan, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Yangfang Li
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neonatology, Children's Hospital of Kunming, Kunming, Yunnan, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Xueping Zhu
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Tongzhen Ji
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Clinical Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
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  • Jinxing Feng
    Affiliations
    Department of Neonatology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
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  • Liping Zhao
    Affiliations
    Department of Neonatology, Inner Mongolia Maternity and Child Health Care Hospital, Hohhot, Inner Mongolia, China
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  • Zhankui Li
    Affiliations
    Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
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  • Lijie Dong
    Affiliations
    Neonatal intensive care unit, Harbin Children's Hospital, Harbin, Heilongjiang, China
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  • Guoqiang Hou
    Affiliations
    Department of Neonatology, Changzhi Maternal and Child Care Hospital, Changzhi, Shanxi, China
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  • Yao Zhu
    Affiliations
    Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China

    Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, Fujian, China
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  • Zhaohui Li
    Affiliations
    Neonatal Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan, China

    Zhengzhou Key Laboratory of Neonatal Disease Research, Zhengzhou, Henan, China
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  • Canlin He
    Affiliations
    Department of Neonatology, Children's Hospital of Kunming, Kunming, Yunnan, China
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  • Haifeng Geng
    Affiliations
    Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
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  • Dan Pang
    Affiliations
    Clinical Laboratory, Inner Mongolia Maternity and Child Health Care Hospital, Hohhot, Inner Mongolia, China
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  • Yajuan Wang
    Correspondence
    Corresponding author: Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing, 100020, China.
    Affiliations
    Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing 100020, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
Published:September 19, 2022DOI:https://doi.org/10.1016/j.jinf.2022.09.014

      Highlights

      • 223 Escherichia coli strains were isolated from neonates in seven hospitals in China.
      • The rates of antimicrobial agent resistance in Escherichia coli isolates were high.
      • The primary multilocus sequence types in Chinese neonates were ST1193 and ST95.
      • Different multilocus sequence types exhibited differences in drug resistance.

      Summary

      Objectives

      Escherichia coli is a common pathogen causing invasive bacterial infections in neonates. In recent years, clinical antimicrobial susceptibility testing has demonstrated an increased rate of drug-resistant E. coli infections. This study aimed to analyse the resistance characteristics of E. coli against common antimicrobial agents, and perform multilocus sequence typing (MLST) in clinical strains of E. coli collected from Chinese neonates.

      Methods

      Culture-positive specimens of E. coli were collected from neonates in seven class A tertiary hospitals located in seven cities across different provinces in China between November 2019 and October 2020. E. coli isolated from these specimens were subjected to antimicrobial susceptibility testing (by broth microdilution method), extended-spectrum β-lactamase (ESBL) detection, and MLST.

      Results

      A total of 223 E. coli strains were isolated, with an overall resistance rate of 87.4%, an ESBL-positive rate of 48.0%, and a multidrug resistance rate of 42.2%. Among the 20 antimicrobial agents tested, E. coli strains showed the highest resistance rates against cefotaxime (59.2%), trimethoprim/sulfamethoxazole (56.5%), doxycycline (39.9%), ciprofloxacin (36.8%), and aztreonam (31.0%). The resistance rates of E. coli strains isolated from children's hospitals against piperacillin/tazobactam, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole, and carbapenems, were significantly higher than those of strains isolated from maternity and child health hospitals. The primary E. coli multilocus sequence types were ST1193, ST95, ST73, ST410, and ST131. The ESBL production rates and multidrug resistance rates of ST1193, ST410, and ST131 were significantly higher than those of ST95 and ST73. Significantly, more strains of E. coli ST1193 and ST410 were isolated from children's hospitals than from maternity and child health hospitals.

      Conclusions

      The rates of antimicrobial agent resistance in E. coli isolates from hospitalised neonates in China were high. The increased number of strains of E. coli ST1193 and ST410 was the reason for higher resistance rates to multiple antimicrobial agents in E. coli from children's hospitals compared with those from maternal and child health hospitals.

      Keywords

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