Objective: To explore the clinical differences between early-onset and late-onset Escherichia coli sepsis in neonates. Methods: A total of 35 neonates with E. coli sepsis admitted into our hospital from Aug. 2012 to Jul. 2021 were enrolled. According to onset time

all patients were divided into 19 cases in the early-onset group (≤3 d after birth) and 16 cases in the late-onset group (>3 d after birth). Clinical indicators and antimicrobial susceptibility of two groups were compared. Results: There were no significant differences in the incidences of meconium-stained amniotic fluid

jaundice

apnea

scleredema

septic shock

necrotizing enterocolitis

disseminated intravascular coagulation and bacterial meningitis between two groups (P>0.05). The incidences of maternal infection

premature rupture of membranes

postnatal asphyxia and abnormal coagulation function in the early-onset group were higher than those in the late-onset group (P<0.05)

while the incidences of abnormal body temperature

vomiting and abdominal distension

hypoglycemia and respiratory failure were lower than those in the late-onset group (P<0.05). The sensitivity rate of E. coli to piperacillin/tazobactam

amikacin

imipenem and meropenem was higher. There was no significant difference in the sensitivity rate of commonly used clinical antibiotics between two groups (P>0.05). Conclusion: The clinical manifestations of early-onset and late-onset E. coli sepsis in neonates are different

yet there is no significant difference in the susceptibility rate to commonly used antibiotics. Clinical detection of the susceptibility of E. coli to antibiotics is helpful for formulating the treatment regimens and reducing the abuse of antibiotics.