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Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network.

Li, G; Bielicki, JA; Ahmed, ASMNU; Islam, MS; Berezin, EN; Gallacci, CB; Guinsburg, R; da Silva Figueiredo, CE; Santarone Vieira, R; Silva, AR; et al. Li, G; Bielicki, JA; Ahmed, ASMNU; Islam, MS; Berezin, EN; Gallacci, CB; Guinsburg, R; da Silva Figueiredo, CE; Santarone Vieira, R; Silva, AR; Teixeira, C; Turner, P; Nhan, L; Orrego, J; Pérez, PM; Qi, L; Papaevangelou, V; Triantafyllidou, P; Iosifidis, E; Roilides, E; Sarafidis, K; Jinka, DR; Nayakanti, RR; Kumar, P; Gautam, V; Prakash, V; Seeralar, A; Murki, S; Kandraju, H; Singh, S; Kumar, A; Lewis, L; Pukayastha, J; Nangia, S; K N, Y; Chaurasia, S; Chellani, H; Obaro, S; Dramowski, A; Bekker, A; Whitelaw, A; Thomas, R; Velaphi, SC; Ballot, DE; Nana, T; Reubenson, G; Fredericks, J; Anugulruengkitt, S; Sirisub, A; Wong, P; Lochindarat, S; Boonkasidecha, S; Preedisripipat, K; Cressey, TR; Paopongsawan, P; Lumbiganon, P; Pongpanut, D; Sukrakanchana, P-O; Musoke, P; Olson, L; Larsson, M; Heath, PT; Sharland, M (2019) Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network. Arch Dis Child, 105 (1). pp. 26-31. ISSN 1468-2044 https://doi.org/10.1136/archdischild-2019-316816
SGUL Authors: Heath, Paul Trafford Sharland, Michael Roy Bielicki, Julia Anna

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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.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Correction available at http://dx.doi.org/10.1136/archdischild-2019-316816corr1
Keywords: antimicrobial resistance, neonatal sepsis, 1103 Clinical Sciences, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services, Pediatrics
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Arch Dis Child
ISSN: 1468-2044
Language: eng
Dates:
DateEvent
16 December 2019Published
24 August 2019Published Online
6 August 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 31446393
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111153
Publisher's version: https://doi.org/10.1136/archdischild-2019-316816

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