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

May 29, 2023

Methicillin-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.
This 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 χ2 test or by Fisher’s exact test in the case of small sample sizes.
A 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.
Low 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.

© 2023. The Author(s).

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REFERENCES & ADDITIONAL READING

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ABOUT THE EXPERTS

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

Department of Infectious Diseases, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102, China.

Chuanqing Wang

Department of Clinical Microbiology Laboratory, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102, China.

Leiyan He

Department of Clinical Microbiology Laboratory, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102, China.

Hongmei Xu

Department of Infectious Diseases, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China.

Chunmei Jing

Department of Clinical Laboratory, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China.

Yinghu Chen

Department of Infectious Diseases, Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, 310052, China.

Jikui Deng

Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, 518038, China.

Aiwei Lin

Department of Infectious Diseases, Qilu Children’s Hospital of Shandong University, Jinan, 250022, China.

Huiling Deng

Department of Infectious Diseases, Xi’an Children’s Hospital, Xi’an, 710003, China.

Huijun Cai

Department of Clinical Laboratory, Xi’an Children’s Hospital, Xi’an, 710003, China.

Yiping Chen

Department of Pediatric Infectious Diseases, Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, China.

Jinhong Yang

Department of Clinical Laboratory, Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, China.

Ting Zhang

Department of Gastroenterology and Infectious Diseases, Children’s Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, 200040, China.

Qing Cao

Department of Infectious Diseases, Shanghai Children’s Medical Center of Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.

Jianhua Hao

Department of Infectious Diseases, Kaifeng Children’s Hospital, Kaifeng, 475000, China.

Yuanyuan Huang

Department of Pediatrics, Bethune First Hospital of Jilin University, Changchun, 130021, China.

Hui Yu

Department of Infectious Diseases, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, 201102, China. yuhui4756@sina.com.