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Observational Study
. 2020 Jan;105(1):26-31.
doi: 10.1136/archdischild-2019-316816. Epub 2019 Aug 24.

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

Grace Li  1 , Julia Anna Bielicki  1   2 , A S M Nawshad Uddin Ahmed  3 , Mohammad Shahidul Islam  3 , Eitan Naaman Berezin  4 , Clery B Gallacci  4 , Ruth Guinsburg  5 , Carlos Eduardo da Silva Figueiredo  6 , Rosilene Santarone Vieira  6 , Andre Ricardo Silva  7 , Cristiane Teixeira  8 , Paul Turner  9 , Ladin Nhan  10 , Jaime Orrego  11 , Paola Marsela Pérez  11 , Lifeng Qi  12 , Vassiliki Papaevangelou  13 , Pinelope Triantafyllidou  14 , Elias Iosifidis  15 , Emmanuel Roilides  15 , Kosmas Sarafidis  15 , Dasaratha Ramaiah Jinka  16 , Raghuprakash Reddy Nayakanti  16 , Praveen Kumar  17 , Vikas Gautam  17 , Vinayagam Prakash  18 , Arasar Seeralar  18 , Srinivas Murki  19 , Hemasree Kandraju  19 , Sanjeev Singh  20 , Anil Kumar  20 , Leslie Lewis  21 , Jayashree Pukayastha  21 , Sushma Nangia  22 , Yogesha K N  22 , Suman Chaurasia  23 , Harish Chellani  24 , Stephen Obaro  25 , Angela Dramowski  26 , Adrie Bekker  26 , Andrew Whitelaw  27   28 , Reenu Thomas  29 , Sithembiso Christopher Velaphi  29 , Daynia Elizabeth Ballot  29 , Trusha Nana  29 , Gary Reubenson  29 , Joy Fredericks  29 , Suvaporn Anugulruengkitt  30 , Anongnart Sirisub  30 , Pimol Wong  31 , Sorasak Lochindarat  32 , Suppawat Boonkasidecha  32 , Kanchana Preedisripipat  33 , Tim R Cressey  33 , Pongsatorn Paopongsawan  34 , Pagakrong Lumbiganon  34 , Dounghatai Pongpanut  35 , Pra-Ornsuda Sukrakanchana  35 , Philippa Musoke  36   37 , Linus Olson  38 , Mattias Larsson  38 , Paul T Heath  1 , Michael Sharland  39
Affiliations
Observational Study

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

Grace Li et al. Arch Dis Child. 2020 Jan.

Erratum in

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: antimicrobial resistance; neonatal sepsis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Factors affecting the apparent burden of antimicrobial resistance (AMR) in the neonatal setting.
See this image and copyright information in PMC

Comment in

References

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