Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days

Figures & data

Table 1 Baseline Characteristics of Included Newborns

Variables	Total (n = 297)
Gender, n (%)
Male	180 (60.61%)
Female	117 (39.39%)
Birth weight, M(Q1, Q3),(g)	3100.00 (2395.00, 3400.00)
Body length, M(Q1, Q3),(cm)	50.00 (47.00, 50.00)
Gestational age, M(Q1, Q3),(Week)	38.57 (35.57, 39.86)
Onset age, M(Q1, Q3), (Day)	6.00 (3.00, 14.00)
Apgar Score 1 min M(Q1, Q3), (Points)	9.00 (8.00, 10.00)
Apgar Score 5 min, M(Q1, Q3), (Points)	10.00 (9.00, 10.00)
PICC (Yes)	50 (16.84%)
Parenteral nutrition, (Yes)	133 (44.78%)
Patient sources
Obstetrics	108 (36.36%)
Outpatient	2 (0.67%)
Community	100 (33.67%)
Other hospital	40 (13.47%)
Hospital stay	47 (15.82%)
TRIPS Score, M (Q1, Q3), (Points)	1.00 (0.00, 13.00)
TRIPS Groups, n (%)
Severe (TRIPS Score ≥ 20)	46 (15.49%)
Non-severe (TRIPS Score < 20)	251 (84.51%)
Neonatal sepsis group, n (%)
EOS	152 (51.18%)
LOS	145 (48.82%)
Jaundice, n (%), (Yes)	153 (51.52%)
Anemia, n (%), (Yes)	84 (28.28%)
Feeding intolerance, n (%), (Yes)	40 (13.47%)
Apnea, n (%), (Yes)	38 (12.79%)
Polypnea, n (%), (Yes)	88 (29.63%)
Fever, n (%), (Yes)	105 (35.35%)
Hemorrhage tendency, n (%), (Yes)	28 (9.43%)
Hepatosplenomegaly, n (%), (Yes)	15 (5.05%)
Other comorbidities, n (%), (Yes)	193 (64.98%)
Outcomes
Survival state, n (%)
Survival	286 (96.30%)
Death	11 (3.70%)
Duration of ICU stay, M(Q1, Q3), (day)	10.00 (8.00, 16.00)
Hospitalization costs, M(Q1, Q3), (yuan)	16187.88 (11348.24, 37449.08)

Abbreviations: PICC, peripherally inserted central catheter; EOS, early-onset neonatal septicemia; LOS, late-onset neonatal septicemia; ICU, intensive care unit.

Figure 1 Frequency of neonatal septicemia with Gram-positive bacteria.

Figure 2 Frequency of neonatal septicemia with Gram-negative bacteria.

Figure 3 Frequency of neonatal septicemia with fungus.

Figure 4 Drug sensitivity for Gram-positive bacteria, Gram-negative bacteria and fungus; (A) drug sensitivity for Gram-positive bacteria; (B) drug sensitivity for Gram-negative bacteria; (C) drug sensitivity for fungus.

Table 2 Univariate Gamma Regression Results

Variables	β	95% CI	P
Baseline information
Gender (female)	0.135	(−0.086, 0.359)	0.234
Birth weight (g)	−0.001	(−0.001, -0.001)	<0.001
Body length (cm)	−0.113	(−0.128, -0.099)	<0.001
Onset age	0.036	(0.027, 0.045)	<0.001
Apgar Score 1 min (points)	−0.321	(−0.438, -0.211)	<0.001
Apgar Score 5 min (points)	−0.113	(−0.128, -0.099)	<0.001
PICC (Yes)	1.229	(1.027, 1.441)	<0.001
Parenteral nutrition (Yes)	0.989	(0.840, 1.139)	<0.001
Patient sources
Obstetrics	REF
Outpatient	−0.416	(−1.227, 0.679)	0.382
Community	−0.338	(−0.519, -0.157)	<0.001
Other hospital	0.274	(0.036, 0.520)	0.027
Hospital stay	1.178	(0.953, 1.410)	<0.001
Standardized prenatal care	−0.139	(−0.497, 0.189)	0.425
Number of pregnancies
Multiple	REF
Single	−0.16	(−0.380, 0.062)	0.157
Parity
Single	REF
Multiple	0.482	(0.086, 0.929)	0.025
Twins	−0.923	(−2.371, 1.805)	0.341
Delivery modes
Cesarean	REF
Vaginal delivery	−0.125	(−0.353, 0.098)	0.277
Preeclampsia (Yes)	0.469	(−0.351, 1.585)	0.331
Premature rupture of membrane (Yes)	0.146	(−0.228, 0.564)	0.469
Fever (Yes)	0.136	(−0.239, 0.555)	0.5
Antibacterial drug use during pregnancy (Yes)	0.743	(−0.706, 3.473)	0.444
Antenatal hemorrhage (Yes)	0.956	(0.031, 2.277)	0.086
Gestational age (Week)	−0.132	(−0.148, -0.116)	<0.001
Complications (Yes)	0.835	(0.649, 1.018)	<0.001
Disease severity
TRIPS score (points)	0.035	(0.025, 0.045)	<0.001
TRIPS groups
Severe (Trips score ≥ 20)	0.781	(0.505, 1.076)	<0.001
Neonatal sepsis groups
EOS	REF
LOS	0.665	(0.481, 0.848)	<0.001
Laboratory value
WBC (10^9/L)	−0.006	(−0.018, 0.006)	0.454
RBC (10^9/L)	−0.372	(−0.513, -0.232)	<0.001
Hb (g/L)	−0.011	(−0.015, -0.008)	<0.001
PLT (10^9/L)	−0.002	(−0.003, -0.001)	<0.001
NC (10^9/L)	−0.001	(−0.016, 0.016)	0.943
LYM (10^9/L)	−0.077	(−0.125, -0.028)	0.006
HCT (L/L)	−3.53	(−4.775, -2.283)	<0.001
I/T neutrophil ratio	1.402	(0.785, 2.035)	<0.001
ALT (U/L)	0.001	(−0.002, 0.005)	0.597
AST (U/L)	0	(−0.001, 0.001)	0.77
TBIL (μmol/L)	−0.004	(−0.005, -0.003)	<0.001
ALB (g/L)	−0.084	(−0.101, -0.067)	<0.001
GLB (g/L)	−0.04	(−0.062, -0.018)	0.002
CRP (mg/L)	0.005	(0.001, 0.010)	0.005
PCT (mg/L)	−0.002	(−0.006, 0.004)	0.475
NC/LYM	0.001	(−0.021, 0.029)	0.964
CKMB (IU/L)	0	(−0.001, 0.001)	0.568
BUN (mmol/L)	0.077	(0.034, 0.124)	<0.001
Cr (μmol/L)	0.003	(−0.003, 0.009)	0.33
Microbiology features
Staphylococcus epidermidis (Yes)	−0.719	(−0.911, -0.524)	<0.001
Escherichia coli (Yes)	−0.422	(−0.776, -0.031)	0.026
Candida parapsilosis (Yes)	1.044	(0.635, 1.509)	<0.001
Staphylococcus haemolyticus (Yes)	−0.001	(−0.454, 0.524)	0.998
Staphylococcus hominis (Yes)	−0.46	(−0.866, -0.001)	0.037
Streptococcus agalactiae (Yes)	−0.044	(−0.432, 0.391)	0.833
Symptom
Jaundice (Yes)	−0.533	(−0.739, -0.327)	<0.001
Anemia (Yes)	0.79	(0.579, 1.006)	<0.001
Feeding intolerance (Yes)	0.646	(0.344, 0.972)	<0.001
Apnea (Yes)	0.99	(0.713, 1.287)	<0.001
Polypnea (Yes)	0.459	(0.228, 0.698)	<0.001
Fever (Yes)	0.373	(0.146, 0.605)	0.002
Hemorrhage tendency (Yes)	0.457	(0.106, 0.846)	0.016
Hepatosplenomegaly (Yes)	0.305	(−0.162, 0.847)	0.234
Tachycardia (Yes)	0.541	(0.244, 0.860)	<0.001
Bradycardia (Yes)	−0.219	(−0.973, 0.39)	0.523
Hypotension (Yes)	0.033	(−0.433, 0.576)	0.896
Decreased responsiveness (Yes)	0.576	(0.338, 0.824)	<0.001
Cyanosis (Yes)	0.682	(0.470, 0.898)	<0.001
Emesis (Yes)	0.03	(−0.339, 0.440)	0.881
Rash (Yes)	−0.451	(−0.706, -0.182)	<0.001
Tic (Yes)	0.088	(−0.325, 0.557)	0.696

Abbreviations: PICC, peripherally inserted central catheter; EOS, early-onset neonatal septicemia; LOS, late-onset neonatal septicemia; WBC, white blood cell; RBC, red blood cell; Hb, hemoglobin; PLT, platelet; NC, neutrophil; LYM, lymphocytotoxicity; HCT, hematokrit; I/T, immature/total; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; ALB, serum albumin; GLB, seroglobulin; CRP, C-reactive protein; PCT, procalcitonin; CKMB, creatine kinase isoenzyme; BUN, blood urea nitrogen; Cr, creatinine.

Table 3 Multivariate Gamma Regression Results

Variables	β	95% CI	P
Baseline information
Body length	−0.024	(−0.044, 0.004)	0.02
Patient source
Obstetric	REF
Outpatient	−0.107	(0.618, 0.496)	0.707
Community	−0.187	(−0.333, -0.039)	0.016
Other hospital	0.183	(0.016, 0.354)	0.035
Hospital stay	0.617	(0.411, 0.825)	<0.001
Parity
Single	REF
Multiple	−0.08	(−0.264, 0.111)	0.396
Twins	−1.325	(−2.139, 0.365)	0.003
Antibacterial drug use during pregnancy (Yes)	1.177	(0.362, 2.136)	0.009
Feeding intolerance(Yes)	0.28	(0.127, 0.437)	<0.001
Bradycardia (Yes)	0.529	(0.196, 0.838)	0.002
Hypotension (Yes)	−0.35	(−0.590, -0.102)	0.01
Comorbidity (Yes)	0.177	(0.063, 0.291)	0.003
Gestational week	−0.034	(−0.059, -0.009)	0.006
Onset age	0.014	(0.006, 0.023)	0.001
Disease severity
TRIPS score	0.01	(0.005, 0.016)	<0.001
Neonatal sepsis groups
EOS	REF
LOS	−0.021	(−0.184, 0.142)	0.804
Microbiology features
Staphylococcus epidermidis (Yes)	0.011	(−0.118, 0.140)	0.861
Escherichia coli (Yes)	−0.086	(−0.266, 0.098)	0.356
Candida parapsilosis (Yes)	0.035	(−0.195, 0.27)	0.765
Staphylococcus haemolyticus (Yes)	0.098	(−0.109, 0.315)	0.363
Staphylococcus hominis (Yes)	−0.133	(−0.335, 0.076)	0.205
Streptococcus agalactiae (Yes)	0.337	(0.140, 0.539)	0.001
Laboratory value
CRP	0.003	(0.002, 0.005)	<0.001
PCT	−0.003	(−0.005, -0.001)	0.014
CKMB	−0.001	(−0.001, 0.00)	<0.001

Abbreviations: EOS, early-onset neonatal septicemia; LOS, late-onset neonatal septicemia; CRP, C-reactive protein; PCT, procalcitonin; CKMB, creatine kinase isoenzyme.