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TOWARDS UNDERSTANDING GLOBAL PATTERNS OF ANTIMICROBIAL USE AND RESISTANCE IN NEONATAL SEPSIS: INSIGHTS FROM THE NEOAMR NETWORK
Li, Grace et al. | Date Issued: 2020
Author
Li, Grace
Bielicki, Julia Anna
Ahmed, A. S. M. Nawshad Uddin
Islam, Mohammad Shahidul
Berezin, Eitan Naaman
Gallacci, Clery B.
Guinsburg, Ruth
Figueiredo, Carlos Eduardo da Silva
Vieira, Rosilene Santarone
Silva, Andre Ricardo
Teixeira, Cristiane
Turner, Paul
Nhan, Ladin
Orrego, Jaime
Pérez, Paola Marsela
Qi, Lifeng
Papaevangelou, Vassiliki
Triantafyllidou, Pinelope
Iosifidis, Elias
Roilides, Emmanuel
Sarafidis, Kosmas
Jinka, Dasaratha Ramaiah
Nayakanti, Raghuprakash Reddy
Kumar, Praveen
Gautam, Vikas
Prakash, Vinayagam
Seeralar, Arasar
Murki, Srinivas
Kandraju, Hemasree
Singh, Sanjeev
Kumar, Anil
Lewis, Leslie
Pukayastha, Jayashree
Nangia, Sushma
N., Yogesha K.
Chaurasia, Suman
Chellani, Harish
Obaro, Stephen
Dramowski, Angela
Bekker, Adrie
Whitelaw, Andrew
Thomas, Reenu
Velaphi, Sithembiso Christopher
Ballot, Daynia Elizabeth
Nana, Trusha
Reubenson, Gary
Fredericks, Joy
Anugulruengkitt, Suvaporn
Sirisub, Anongnart
Wong, Pimol
Lochindarat, Sorasak
Boonkasidecha, Suppawat
Preedisripipat, Kanchana
Cressey, Tim R.
Paopongsawan, Pongsatorn
Lumbiganon, Pagakrong
Pongpanut, Dounghatai
Sukrakanchana, Pra-Ornsuda
Musoke, Philippa
Olson, Linus
Larsson, Mattias
Heath, Paul T.
Sharland, Michael
Affilliation
University of London. St George's. Institute of Infection and Immunity. Paediatric Infectious Diseases Research Group. London, UK.
University of London. St George's. Institute of Infection and Immunity. Paediatric Infectious Diseases Research Group. London, UK / University of Basel Children's Hospital. Paediatric Pharmacology and Pharmacometrics Research. Basel, Switzerland.
Child Health Research Foundation. Dhaka Shishu Hospital. Dhaka, Bangladesh.
Child Health Research Foundation. Dhaka Shishu Hospital. Dhaka, Bangladesh.
Santa Casa Medical School. São Paulo, SP, Brazil.
Santa Casa Medical School. São Paulo, SP, Brazil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.
Federal Fluminense University. Rio de Janeiro, RJ, Brazil.
Prontobaby Children's Hospital. Rio de Janeiro, RJ, Brazil.
Cambodia Oxford Medical Research Unit. Siem Reap, Cambodia.
Angkor Hospital for Children. Siem Reap, Cambodia.
Fundación Valle Del Lili. Santiago de Cali, Colombia.
Fundación Valle Del Lili. Santiago de Cali, Colombia.
Shenzhen Children's Hospital. Shenzhen, China.
National and Kapodistrian University of Athens.Third Department of Pediatrics. Athens, Greece.
Attikon University General Hospital. Athens, Greece.
Aristotle University. School of Health Sciences. Thessaloniki, Greece.
Aristotle University. School of Health Sciences. Thessaloniki, Greece.
Aristotle University. School of Health Sciences. Thessaloniki, Greece.
Rural Development Trust Hospital. Department of Paediatrics. Bathalapalli, India.
Rural Development Trust Hospital. Department of Paediatrics. Bathalapalli, India.
Post Graduate Institute of Medical Education and Research. Paediatrics. Chandigarh, India.
Post Graduate Institute of Medical Education and Research. Paediatrics. Chandigarh, India.
Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children. Chennai, India.
Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children. Chennai, India.
Fernandez Hospital. Department of Neonatology. Hyderabad, India.
Fernandez Hospital. Department of Neonatology. Hyderabad, India.
Amrita Institute of Medical Sciences. Kochi, India.
Amrita Institute of Medical Sciences. Kochi, India.
Kasturba Medical College. Manipal, India.
Kasturba Medical College. Manipal, India.
Lady Hardinge Medical College. New Delhi, India.
Lady Hardinge Medical College. New Delhi, India.
All India Institute of Medical Sciences. New Delhi, India.
Vardhman Mahavir Medical College and Safdarjung Hospital. New Delhi, India.
International Foundation Against Infectious Disease in Nigeria. Omaha, Nebraska, USA.
Stellenbosch University. Faculty of Medicine and Health Sciences. Department of Paediatrics and Child Health. Stellenbosch, South Africa.
Stellenbosch University. Faculty of Medicine and Health Sciences. Department of Paediatrics and Child Health. Stellenbosch, South Africa.
Stellenbosch University. Faculty of Medicine and Health Sciences. Division of Medical Microbiology. Stellenbosch, South Africa / National Health Laboratory Service. Tygerberg Hospital. Cape Town, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
University of the Witwatersrand. Johannesburg, South Africa.
Chulalongkorn University. Bangkok, Thailand.
Chulalongkorn University. Bangkok, Thailand.
Mahidol University. Faculty of Medicine Siriraj Hospital. Bangkok, Thailand.
Queen Sirikit National Institute of Child Health. Bangkok, Thailand.
Queen Sirikit National Institute of Child Health. Bangkok, Thailand.
Chiangrai Prachanukroh Hospital. Chiang Rai, Thailand.
Chiangrai Prachanukroh Hospital. Chiang Rai, Thailand.
Khon Kaen University. Department of Paediatrics. Khon Kaen, Thailand.
Khon Kaen University. Department of Paediatrics. Khon Kaen, Thailand.
Phayao Hospital. Phayao, Thailand.
Phayao Hospital. Phayao, Thailand.
Makerere University. Paediatrics and Child Health. Kampala, Kampala, Uganda / Mulago Hospital. Kampala, Uganda.
Karolinska Institute in collaboration with Vietnam National Children's Hospital within Training and Research Academic Collaboration Sweden - Vietnam. Hanoi, Vietnam.
Karolinska Institute in collaboration with Vietnam National Children's Hospital within Training and Research Academic Collaboration Sweden - Vietnam. Hanoi, Vietnam.
University of London. St George's. Institute of Infection and Immunity. Paediatric Infectious Diseases Research Group. London, UK.
University of London. St George's. Institute of Infection and Immunity. Paediatric Infectious Diseases Research Group. London, UK.
Abstract
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 '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.
Keywords in Portuguese
Antimicrobial resistance
Neonatal sepsis
Neonatal units (NNUs)
Antimicrobial resistance (AMR)
 
Publisher
British Medical Association
Citation
LI, Grace et al. Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network. Archives of Disease in Childhood, v. 105, n. 1, p. 26-31, Jan. 2020.
DOI
10.1136/archdischild-2019-316816
ISSN
0003-9888
Notes
Contém Errata.