Epidemiology and antimicrobial susceptibility of invasive Escherichia coli infection in neonates from 2012 to 2019 in Xiamen, China

Background Escherichia coli ( E. coli ) is one of the important causative pathogens of neonatal invasive infection. The epidemiological and clinical profile of invasive E. coli infection in Chinese newborns is not well characterized. Methods Ninety-four infants with invasive E. coli infection were categorized into E. coli early onset disease (EOD) group (onset ≤72 h after birth) ( n = 46) and E. coli late onset disease (LOD) group (onset > 72 h) ( n = 48). We compared and analyzed the clinical characteristics and drug sensitivity profile of early-onset and late-onset E. coli invasive infection in neonates. Results The incidence of E. coli -EOD and E.coli -LOD was 0.45/1000 live births (LBs) and 0.47/1000 LBs, respectively. The incidence of gestational diabetes mellitus, perinatal fever, urinary tract infection, chorioamnionitis, and positive E. coli culture among mothers in the E. coli -EOD group were significantly higher than that in E. coli -LOD group. The incidence of premature birth, low-birth-weight, nosocomial infection, and hospitalization time were significantly higher in the E. coli -LOD group. The main disease in E. coli -EOD group was pneumonia (main clinical manifestation: dyspnea). The main disease in E. coli -LOD group was sepsis (main clinical manifestation: fever). The sensitivity rates of E. coli strains to ampicillin and piperacillin were low (25.00–28.79%); sensitivity to cephalosporins was also low except ceftazidime (lowest sensitivity rate: 57.14%). Sensitivity to compound preparations containing β-lactamase inhibitors was high, even for extended spectrum β-lactamase-positive strains (nearly 100%). Conclusion E. coli is an important cause of invasive infection of newborns in Xiamen, China. E. coli -EOD was largely attributable to perinatal factors, while E. coli -LOD was largely related to nosocomial infection. Compound preparations containing β-lactamase inhibitor or carbapenem antibiotics should be preferred for neonatal invasive infection by E. coli .