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

Grace Li, Julia Anna Bielicki, A. S.M.Nawshad Uddin Ahmed, Mohammad Shahidul Islam, Eitan Naaman Berezin, Clery B. Gallacci, Ruth Guinsburg, Carlos Eduardo Da Silva Figueiredo, Rosilene Santarone Vieira, Andre Ricardo Silva, Cristiane Teixeira, Paul Turner, Ladin Nhan, Jaime Orrego, Paola Marsela Pérez, Lifeng Qi, Vassiliki Papaevangelou, Pinelope Triantafyllidou, Elias Iosifidis, Emmanuel RoilidesKosmas Sarafidis, Dasaratha Ramaiah Jinka, Raghuprakash Reddy Nayakanti, Praveen Kumar, Vikas Gautam, Vinayagam Prakash, Arasar Seeralar, Srinivas Murki, Hemasree Kandraju, Sanjeev Singh, Anil Kumar, Leslie Lewis, Jayashree Pukayastha, Sushma Nangia, K. Yogesha, Suman Chaurasia, Harish Chellani, Stephen Obaro, Angela Dramowski, Adrie Bekker, Andrew Whitelaw, Reenu Thomas, Sithembiso Christopher Velaphi, Daynia Elizabeth Ballot, Trusha Nana, Gary Reubenson, Joy Fredericks, Suvaporn Anugulruengkitt, Anongnart Sirisub, Pimol Wong, Sorasak Lochindarat, Suppawat Boonkasidecha, Kanchana Preedisripipat, Tim R. Cressey, Pongsatorn Paopongsawan, Pagakrong Lumbiganon, Dounghatai Pongpanut, Pra Ornsuda Sukrakanchana, Philippa Musoke, Linus Olson, Mattias Larsson, Paul T. Heath, Michael Sharland

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 â € 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.

Original languageEnglish
JournalArchives of Disease in Childhood
DOIs
Publication statusAccepted/In press - 01-01-2019

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Observational Studies
Cephalosporin Resistance
Carbapenems
Glycopeptides
Live Birth
Infant Mortality
Cohort Studies
Newborn Infant
Databases
Guidelines
Neonatal Sepsis
Therapeutics
Research
Surveys and Questionnaires
Blood Culture

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Li, Grace ; Bielicki, Julia Anna ; Ahmed, A. S.M.Nawshad Uddin ; Islam, Mohammad Shahidul ; Berezin, Eitan Naaman ; Gallacci, Clery B. ; Guinsburg, Ruth ; Da Silva Figueiredo, Carlos Eduardo ; Santarone Vieira, Rosilene ; 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 ; 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. / Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis : Insights from the NeoAMR network. In: Archives of Disease in Childhood. 2019.
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title = "Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: Insights from the NeoAMR network",
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 {\^a} € 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.",
author = "Grace Li and Bielicki, {Julia Anna} and Ahmed, {A. S.M.Nawshad Uddin} and Islam, {Mohammad Shahidul} and Berezin, {Eitan Naaman} and Gallacci, {Clery B.} and Ruth Guinsburg and {Da Silva Figueiredo}, {Carlos Eduardo} and {Santarone Vieira}, Rosilene and Silva, {Andre Ricardo} and Cristiane Teixeira and Paul Turner and Ladin Nhan and Jaime Orrego and P{\'e}rez, {Paola Marsela} and Lifeng Qi and Vassiliki Papaevangelou and Pinelope Triantafyllidou and Elias Iosifidis and Emmanuel Roilides and Kosmas Sarafidis and Jinka, {Dasaratha Ramaiah} and Nayakanti, {Raghuprakash Reddy} and Praveen Kumar and Vikas Gautam and Vinayagam Prakash and Arasar Seeralar and Srinivas Murki and Hemasree Kandraju and Sanjeev Singh and Anil Kumar and Leslie Lewis and Jayashree Pukayastha and Sushma Nangia and K. Yogesha and Suman Chaurasia and Harish Chellani and Stephen Obaro and Angela Dramowski and Adrie Bekker and Andrew Whitelaw and Reenu Thomas and Velaphi, {Sithembiso Christopher} and Ballot, {Daynia Elizabeth} and Trusha Nana and Gary Reubenson and Joy Fredericks and Suvaporn Anugulruengkitt and Anongnart Sirisub and Pimol Wong and Sorasak Lochindarat and Suppawat Boonkasidecha and Kanchana Preedisripipat and Cressey, {Tim R.} and Pongsatorn Paopongsawan and Pagakrong Lumbiganon and Dounghatai Pongpanut and Sukrakanchana, {Pra Ornsuda} and Philippa Musoke and Linus Olson and Mattias Larsson and Heath, {Paul T.} and Michael Sharland",
year = "2019",
month = "1",
day = "1",
doi = "10.1136/archdischild-2019-316816",
language = "English",
journal = "Archives of Disease in Childhood",
issn = "0003-9888",
publisher = "BMJ Publishing Group",

}

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, Yogesha, K, 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, PO, 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', Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2019-316816

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis : Insights from the NeoAMR network. / Li, Grace; Bielicki, Julia Anna; Ahmed, A. S.M.Nawshad Uddin; Islam, Mohammad Shahidul; Berezin, Eitan Naaman; Gallacci, Clery B.; Guinsburg, Ruth; Da Silva Figueiredo, Carlos Eduardo; Santarone Vieira, Rosilene; 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; 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.

In: Archives of Disease in Childhood, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis

T2 - Insights from the NeoAMR network

AU - Li, Grace

AU - Bielicki, Julia Anna

AU - Ahmed, A. S.M.Nawshad Uddin

AU - Islam, Mohammad Shahidul

AU - Berezin, Eitan Naaman

AU - Gallacci, Clery B.

AU - Guinsburg, Ruth

AU - Da Silva Figueiredo, Carlos Eduardo

AU - Santarone Vieira, Rosilene

AU - Silva, Andre Ricardo

AU - Teixeira, Cristiane

AU - Turner, Paul

AU - Nhan, Ladin

AU - Orrego, Jaime

AU - Pérez, Paola Marsela

AU - Qi, Lifeng

AU - Papaevangelou, Vassiliki

AU - Triantafyllidou, Pinelope

AU - Iosifidis, Elias

AU - Roilides, Emmanuel

AU - Sarafidis, Kosmas

AU - Jinka, Dasaratha Ramaiah

AU - Nayakanti, Raghuprakash Reddy

AU - Kumar, Praveen

AU - Gautam, Vikas

AU - Prakash, Vinayagam

AU - Seeralar, Arasar

AU - Murki, Srinivas

AU - Kandraju, Hemasree

AU - Singh, Sanjeev

AU - Kumar, Anil

AU - Lewis, Leslie

AU - Pukayastha, Jayashree

AU - Nangia, Sushma

AU - Yogesha, K.

AU - Chaurasia, Suman

AU - Chellani, Harish

AU - Obaro, Stephen

AU - Dramowski, Angela

AU - Bekker, Adrie

AU - Whitelaw, Andrew

AU - Thomas, Reenu

AU - Velaphi, Sithembiso Christopher

AU - Ballot, Daynia Elizabeth

AU - Nana, Trusha

AU - Reubenson, Gary

AU - Fredericks, Joy

AU - Anugulruengkitt, Suvaporn

AU - Sirisub, Anongnart

AU - Wong, Pimol

AU - Lochindarat, Sorasak

AU - Boonkasidecha, Suppawat

AU - Preedisripipat, Kanchana

AU - Cressey, Tim R.

AU - Paopongsawan, Pongsatorn

AU - Lumbiganon, Pagakrong

AU - Pongpanut, Dounghatai

AU - Sukrakanchana, Pra Ornsuda

AU - Musoke, Philippa

AU - Olson, Linus

AU - Larsson, Mattias

AU - Heath, Paul T.

AU - Sharland, Michael

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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 â € 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.

AB - 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 â € 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.

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