Clinical Characteristics and Risk Factors for Neonatal Bloodstream Infection Due to Carbapenem-Resistant Enterobacteriaceae: A Single-Center Chinese Retrospective Study

Objectives To analyze the clinical characteristics and risk factors for bloodstream infections (BSIs) caused by carbapenem-resistant Enterobacteriaceae (CRE) in neonates. Methods This single-center, retrospective study included all patients with BSIs admitted to a neonatal intensive care unit between Jan 1, 2015 to Apr 30, 2022. The clinical and microbiological data of patients were collected; predictors of 30-day mortality in patients with CRE BSIs were also identified in this study. Results Among the 224 neonates with Enterobacteriaceae BSIs, 39.29% (88/224) of the patients developed CRE BSIs. The 30-day mortality rate reached up to 21.59% (19/88). The Quick Sequential Organ Failure Assessment score > 2 (odds ratio [OR] and 95% credibility interval [CI]: 3.852[1.111–13.356], P < 0.05), prior to more than two kinds of antibiotics use (OR and 95% CI: 9.433 [1.562–56.973], P < 0.05), pneumonia (OR and 95% CI: 3.847 [1.133–13.061], P < 0.05), and cesarean section (OR and 95% CI: 2.678 [1.225–5.857], P < 0.05) were independent risk factors associated with CRE BSIs. Moreover, the risk factors for mortality in neonates with CRE BSIs were significantly associated with neonatal Sequential Organ Failure Assessment score > 6 (OR and 95% CI: 16.335 [1.446–184.517], P < 0.05). Conclusion Prior to more than two kinds of antibiotics use, Quick Sequential Organ Failure Assessment score > 2, pneumonia and cesarean section were independent risk factors for CRE BSIs. The Neonatal Sequential Organ Failure Assessment score > 6 was a risk factor for mortality associated with CRE BSIs.