{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:13Z","timestamp":1788415933017,"version":"build-2803163510"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neonatal sepsis remains a leading cause of mortality and long-term disability worldwide. The coronavirus disease 2019 (COVID-19) prevention measures effectively curbed viral transmission. However, evidence of their long-term impact on the pathogen spectrum and antimicrobial resistance in neonatal sepsis is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective observational study at Henan Children\u2019s Hospital, 894 neonates with culture-confirmed sepsis (2015\u20132024) were enrolled. Using pandemic policy time points, we divided the study into three phases and compared pathogen spectrum and antimicrobial resistance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among neonates with sepsis, preterm proportion increased from 32.5% to 46.2%. The pathogen spectrum shifted from Gram-positive to Gram-negative predominance.\n                      <jats:italic>Coagulase-negative staphylococci<\/jats:italic>\n                      (CoNS) detection declined from 36.6% to 9.8%, a trend consistent across preterm\/full-term and early-onset\/late-onset subgroups.\n                      <jats:italic>Klebsiella pneumoniae (K. pneumoniae<\/jats:italic>\n                      ) maintained high resistance to third-generation cephalosporins, while\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (\n                      <jats:italic>E. coli<\/jats:italic>\n                      ) showed a numerical increase in ceftazidime resistance. In contrast, CoNS and\n                      <jats:italic>Enterococcus faecium<\/jats:italic>\n                      (\n                      <jats:italic>E. faecium<\/jats:italic>\n                      ) remained susceptible to vancomycin and linezolid.\n                      <jats:italic>E. coli<\/jats:italic>\n                      maintained favorable susceptibility to carbapenems and piperacillin-tazobactam, whereas\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      showed a fluctuating carbapenem resistance trend that initially increased then declined, though it remained susceptible to tigecycline. All-cause mortality increased from 1.4% to 5.4%, with Gram-negative bacteria predominating in fatal cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Enhanced hand hygiene and contact isolation are consistent with a sustained decline in CoNS, but show limited association with changes in Gram-negative bacilli. Routine surveillance and optimized empirical therapy remain crucial for improving neonatal sepsis outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1913607","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:13:29Z","timestamp":1788412409000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends in pathogens and antimicrobial resistance in culture-proven neonatal sepsis over a decade (2015\u20132024): the impact of COVID-19 pandemic"],"prefix":"10.3389","volume":"16","author":[{"given":"Fatao","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neonatology, Children\u2019s Hospital Affiliated to Zhengzhou University, Henan Children\u2019s Hospital, Zhengzhou Children\u2019s Hospital","place":["Zhengzhou, 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