OBJECTIVE To investigate the drug sensitivity and changes of blood lactic acid, C-reactive protein (hs-CRP) and heparin-binding protein (HBP) levels in neonatal hyperbilirubinemia (NHB) with infection so as to provide guidance for clinical diagnosis and treatment.

METHODS Totally 61 NHB with infection (the infection group) and 63 NHB without infection (the non-infected group) admitted to the Second Affiliated Hospital of Hainan Medical College from Jan. 2021 to Jan. 2024 were selected. The pathogenic bacteria distributions and drug susceptibility were analyzed, the levels of blood lactic acid, hs-CRP and HBP between the two groups were compared, and the diagnostic values of single and combined detection of blood lactic acid, hs-CRP and HBP in NHB with infection were analyzed.

RESULTS Seventy-six strains of pathogenic bacteria were detected from the infection group. Gram-positive bacteria accounted predominantly for 86.84%, mainly are Staphylococcus epidermidis (27.63%) and Staphylococcus haemolyticus (26.32%), and followed by gram-negative bacteria 13.16%. S. epidermidis and S. haemolyticus were seriously resistant to erythromycin and oxacillin. Blood lactic acid, hs-CRP and HBP levels in the infection group (5.59±1.76) mmol/L, (15.08±4.98) mg/L and (48.37±16.12) ng/ml, respectively were significantly higher than those in the non-infected group (P < 0.05). The area under the curve (AUC) values of the combined detection of blood lactic acid, hs-CRP and HBP for NHB with infection was higher than that of single detection (P < 0.05) with the sensitivity of 96.72% and specificity of 82.54%.

CONCLUSIONS The main pathogenic bacteria of NHB with infection are S. epidermidis and S. hemolyticus, which were seriously resistant to erythromycin and oxacillin. The levels of blood lactic acid, hs-CRP and HBP are highly expressed in NHB with infection, and their combined detection possesses high diagnostic values.