TY - JOUR
T1 - Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis
T2 - Insights from the NeoAMR network
AU - Li, Grace
AU - Bielicki, Julia Anna
AU - Ahmed, A. S.M.Nawshad Uddin
AU - Islam, Mohammad Shahidul
AU - Berezin, Eitan Naaman
AU - Gallacci, Clery B.
AU - Guinsburg, Ruth
AU - Da Silva Figueiredo, Carlos Eduardo
AU - Santarone Vieira, Rosilene
AU - Silva, Andre Ricardo
AU - Teixeira, Cristiane
AU - Turner, Paul
AU - Nhan, Ladin
AU - Orrego, Jaime
AU - Pérez, Paola Marsela
AU - Qi, Lifeng
AU - Papaevangelou, Vassiliki
AU - Triantafyllidou, Pinelope
AU - Iosifidis, Elias
AU - Roilides, Emmanuel
AU - Sarafidis, Kosmas
AU - Jinka, Dasaratha Ramaiah
AU - Nayakanti, Raghuprakash Reddy
AU - Kumar, Praveen
AU - Gautam, Vikas
AU - Prakash, Vinayagam
AU - Seeralar, Arasar
AU - Murki, Srinivas
AU - Kandraju, Hemasree
AU - Singh, Sanjeev
AU - Kumar, Anil
AU - Lewis, Leslie
AU - Pukayastha, Jayashree
AU - Nangia, Sushma
AU - Yogesha, K.
AU - Chaurasia, Suman
AU - Chellani, Harish
AU - Obaro, Stephen
AU - Dramowski, Angela
AU - Bekker, Adrie
AU - Whitelaw, Andrew
AU - Thomas, Reenu
AU - Velaphi, Sithembiso Christopher
AU - Ballot, Daynia Elizabeth
AU - Nana, Trusha
AU - Reubenson, Gary
AU - Fredericks, Joy
AU - Anugulruengkitt, Suvaporn
AU - Sirisub, Anongnart
AU - Wong, Pimol
AU - Lochindarat, Sorasak
AU - Boonkasidecha, Suppawat
AU - Preedisripipat, Kanchana
AU - Cressey, Tim R.
AU - Paopongsawan, Pongsatorn
AU - Lumbiganon, Pagakrong
AU - Pongpanut, Dounghatai
AU - Sukrakanchana, Pra Ornsuda
AU - Musoke, Philippa
AU - Olson, Linus
AU - Larsson, Mattias
AU - Heath, Paul T.
AU - Sharland, Michael
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objective: To gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR). Design: A web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns. Setting: 39 NNUs from 12 countries. Patients: Any neonate admitted to one of the participating NNUs. Interventions: This was an observational cohort study. Results: The number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions <32 weeks ranged from 0% to 19%, and the majority of units (26/39, 66%) use Essential Medicines List â € Access' antimicrobials as their first-line treatment in neonatal sepsis. Cephalosporin resistance rates in Gram-negative isolates ranged from 26% to 84%, and carbapenem resistance rates ranged from 0% to 81%. Glycopeptide resistance rates among Gram-positive isolates ranged from 0% to 45%. Conclusion: AMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.
AB - Objective: To gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR). Design: A web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns. Setting: 39 NNUs from 12 countries. Patients: Any neonate admitted to one of the participating NNUs. Interventions: This was an observational cohort study. Results: The number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions <32 weeks ranged from 0% to 19%, and the majority of units (26/39, 66%) use Essential Medicines List â € Access' antimicrobials as their first-line treatment in neonatal sepsis. Cephalosporin resistance rates in Gram-negative isolates ranged from 26% to 84%, and carbapenem resistance rates ranged from 0% to 81%. Glycopeptide resistance rates among Gram-positive isolates ranged from 0% to 45%. Conclusion: AMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.
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U2 - 10.1136/archdischild-2019-316816
DO - 10.1136/archdischild-2019-316816
M3 - Article
AN - SCOPUS:85071514890
SN - 0003-9888
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
ER -
