OBJECTIVE To explore the distribution and drug resistance trends of the main pathogens causing bloodstream infections (BSI) in neonatal intensive care unit (NICU) of Henan Province from 2014 to 2023 so as to provide bases for prevention and control of hospital-associated infections in the neonates and reasonable use of antibiotics in the whole province.

METHODS The data regarding to the pathogens causing BSI in the NICU neonates and drug resistance were retrospectively collected from Jan. 2014 to Dec. 2023, and the statistical analysis was performed by SPSS 26.0 and WHONET 5.6 software.

RESULTS Totally 27, 984 strains of pathogens were collected from 2014 to 2023, 13, 547(48.41%)of which were gram-negative bacteria, and 14, 437(51.59%) were gram-positive bacteria. Klebsiella pneumoniae (4221 strains, 15.08%), Escherichia coli (3735 strains, 13.35%), Acinetobacter baumannii (1288 strains, 4.60%), Enterobacter cloacae (847 strains, 3.12%) and Pseudomonas aeruginosa (655 strain, 2.34%) were the major species of gram-negative bacteria; Staphylococcus aureus (4545 strains, 16.24%), Staphylococcus epidermidis (3306 strains, 11.81%), Staphylococcus haemolyticus (2048 strains, 7.32%), Staphylococcus hominis (1085 strains, 3.88%) and Enterococcus faecalis (946 strains, 3.38%) were the predominant species of gram-positive bacteria. The drug resistant analysis indicated that the drug resistance rate of the K. pneumoniae strains to imipenem showed an upward trend during the past six years, peaking at 44.23%, and it began to decline in 2021; though the drug resistance rate of the E. coli strains to imipenem showed some fluctuations, it generally presented a downward trend, peaking at 7.00%. The drug resistance rates of the K. pneumoniae strains to the third generation of cephalosporins and carbapenems were higher than those of the E. coli, and there was significant difference in the antimicrobial prevalence trend between the two species of Enterobacter during the ten years (P < 0.05).

CONCLUSIONS K. pneumoniae and coagulase-negative Staphylococcus are dominant among the pathogens causing BSI in the ICU neonates of the whole province, and the isolation rates of drug-resistant strains are high. It is grossly necessary for the reasonable clinical use of antibiotics to carry out the bacterial drug resistance surveillance.