Abstract: Objective To explore the distribution of pathogenic bacteria, drug resistance and drug use in cases of neonatal necrotizing enterocolitis (NEC) with sepsis. Methods The clinical data of neonates diagnosed with necrotizing enterocolitis (NEC) complicated with sepsis in our hospital between 2019 and 2023 was collected to conduct a retrospective study of their clinical characteristics, distribution of pathogenic bacteria and use of antimicrobial drugs. Results A total of 155 clinical cases were included, High-risk factors for necrotizing enterocolitis and sepsis included intrauterine distress, pulmonary infection, respiratory failure, septic shock, and generalized peritonitis. In the study group (n=39), 14 strains (28.57%) of Enterococcus faecium were identified as pathogenic, exhibiting 100% resistance to penicillin and macrolides. Klebsiella pneumoniae showed the highest resistance to piperacillin (87.76%) and meropenem (14.29%). In the control group (n=116), the most common pathogen was Escherichia coli (21 strains, 33.33%), which exhibited the highest resistance to ampicillin (89.0%). In the study group, the resistance rates of Klebsiella pneumoniae to gentamicin, cefotaxime, cefepime, tranexamic acid, and amoxicillin/clavulanic acid were significantly higher than those in the control group (P<0.05). Among the 39 cases of neonatal necrotizing enterocolitis complicated with sepsis in the study group, the most frequently used antibiotics were meropenem (27 cases, 69.23%), cefoperazone-sulbactam (24 cases, 61.54%), and vancomycin (15 cases, 38.46%). Conclusion The pathogenic bacteria among children with NEC combined with sepsis are mostly enterococci and Enterobacteriaceae bacteria, and the anti-infective treatment regimens in our hospital are generally well-grounded. The resistance rate to meropenem should be taken into account clinically.

Key words: Necrotizing Enterocolitis, Neonates, Sepsis, Pathogen, Meropenem, Drug Resistance, Drug Analysis