TY - JOUR
T1 - Antimicrobial resistance in UK neonatal units
T2 - NeonIN infection surveillance network
AU - Cailes, Benjamin
AU - Kortsalioudaki, Christina
AU - Buttery, Jim
AU - Pattnayak, Santosh
AU - Greenough, Anne
AU - Matthes, Jean
AU - Bedford Russell, Alison
AU - Kennea, Nigel
AU - Heath, Paul T.
AU - on behalf of the neonIN network
PY - 2018/9
Y1 - 2018/9
N2 - Objective To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK. Design Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014. Setting 30 neonatal units in the UK. Patients Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics. Results 1568 isolates with recorded antimicrobial data were collected including 328 early-onset sepsis (EOS) isolates and 1240 late-onset sepsis (LOS) isolates. The majority of EOS pathogens (>92%) were susceptible to the four empirical commonly used antimicrobial combinations (eg, 93% for benzylpenicillin/gentamicin), while LOS pathogens demonstrated higher levels of resistance (eg, 89% for flucloxacillin/gentamicin). Among infants<1500 g and <32 weeks gestation, an amoxicillin/gentamicin combination demonstrated a trend towards improved coverage of EOS isolates than benzylpenicillin/gentamicin (93% vs 86%, p=0.211). Conclusions This analysis provides insights into the patterns of antimicrobial resistance among UK neonatal pathogens. These data will inform areas of future research and can be used to update national evidence-based guidelines on antimicrobial usage.
AB - Objective To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK. Design Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014. Setting 30 neonatal units in the UK. Patients Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics. Results 1568 isolates with recorded antimicrobial data were collected including 328 early-onset sepsis (EOS) isolates and 1240 late-onset sepsis (LOS) isolates. The majority of EOS pathogens (>92%) were susceptible to the four empirical commonly used antimicrobial combinations (eg, 93% for benzylpenicillin/gentamicin), while LOS pathogens demonstrated higher levels of resistance (eg, 89% for flucloxacillin/gentamicin). Among infants<1500 g and <32 weeks gestation, an amoxicillin/gentamicin combination demonstrated a trend towards improved coverage of EOS isolates than benzylpenicillin/gentamicin (93% vs 86%, p=0.211). Conclusions This analysis provides insights into the patterns of antimicrobial resistance among UK neonatal pathogens. These data will inform areas of future research and can be used to update national evidence-based guidelines on antimicrobial usage.
KW - epidemiology
KW - infectious diseases
KW - intensive care
KW - neonatology
UR - http://www.scopus.com/inward/record.url?scp=85047083173&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2017-313238
DO - 10.1136/archdischild-2017-313238
M3 - Article
C2 - 29074716
AN - SCOPUS:85047083173
VL - 103
SP - F474-F478
JO - Archives of Disease in Childhood: Fetal and Neonatal Edition
JF - Archives of Disease in Childhood: Fetal and Neonatal Edition
SN - 1359-2998
IS - 5
ER -