Τίτλος:
Epidemiology of infections and antimicrobial use in Greek Neonatal Units
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective To describe the epidemiology of neonatal infections and of antimicrobial use in Greek Neonatal Units (NNUs) in order to develop national, evidence-based guidelines on empiric antimicrobial use for neonatal sepsis in Greece. Design Retrospective analysis of prospectively collected infection surveillance data from 2012 to 2015, together with a Point Prevalence Survey (PPS) on antimicrobial use and the collection of data on local empiric antimicrobial policies. Setting 16 NNUs in Greece participating in the neonIN infection surveillance network Patients Newborns in participating NNUs who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of antibiotics. Results 459 episodes were recorded in 418 infants. The overall incidence of infection was 50/1000 NNU-admissions. The majority of episodes were late-onset sepsis (LOS) (413, 90%). Coagulase-negative Staphylococci (80%) were the most common Gram-positive organisms causing LOS and Klebsiella spp (39%) the most common Gram-negative. Nearly half (45%) of the Klebsiella spp were resistant to at least one aminoglycoside. The PPS revealed that 196 of 484 (40%) neonates were on antimicrobials. The survey revealed wide variation in empiric antimicrobial policies for LOS. Conclusions This is the largest collection of data on the epidemiology of neonatal infections in Greece and on neonatal antimicrobial use. It provides the background for the development of national evidence-based guidelines. Continuous surveillance, the introduction of antimicrobial stewardship interventions and evidence-based guidelines are urgently required. © 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC.
Συγγραφείς:
Gkentzi, D.
Kortsalioudaki, C.
Cailes, B.C.
Zaoutis, T.
Kopsidas, J.
Tsolia, M.
Spyridis, N.
Siahanidou, S.
Sarafidis, K.
Heath, P.T.
Dimitriou, G.
Περιοδικό:
Archives of Disease in Childhood. Fetal and Neonatal Edition
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
aminoglycoside; ampicillin; antiinfective agent; cefotaxime; flucloxacillin; gentamicin; penicillin G; piperacillin; tazobactam; antiinfective agent, antimicrobial stewardship; Article; cerebrospinal fluid; coagulase negative Staphylococcus; disease surveillance; drug use; evidence based practice; female; gestational age; Greece; health care policy; health survey; human; Klebsiella; major clinical study; male; newborn; newborn infection; nonhuman; population; practice guideline; prevalence; priority journal; prospective pricing; retrospective study; urine culture; antibiotic resistance; clinical practice; clinical trial; combination drug therapy; cross infection; drug utilization; incidence; microbial sensitivity test; microbiology; multicenter study; neonatal intensive care unit; newborn sepsis; procedures; statistics and numerical data, Anti-Infective Agents; Cross Infection; Drug Resistance, Bacterial; Drug Therapy, Combination; Drug Utilization; Female; Gestational Age; Greece; Humans; Incidence; Infant, Newborn; Intensive Care Units, Neonatal; Male; Microbial Sensitivity Tests; Neonatal Sepsis; Practice Patterns, Physicians'; Retrospective Studies
DOI:
10.1136/archdischild-2018-315024
