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Title: Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: Insights from the NeoAMR network
Authors: 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 Roilides
Kosmas 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. N. 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
Shenzhen Children's Hospital
Fundación Valle del Lili
Mulago Hospital
Makerere University
Government General Hospital Chennai
St George's University of London
National and Kapodistrian University of Athens
Chulalongkorn University
Dhaka Shishu Hospital
Lady Hardinge Medical College
Fundacao Oswaldo Cruz
Khon Kaen University
VMMC & Safdarjang Hospital
University of Witwatersrand
Kasturba Medical College, Manipal
Attikon University Hospital
Aristotle University of Thessaloniki
Universidade Federal de Sao Paulo
Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo
Karolinska Institutet
Faculty of Medicine, Siriraj Hospital, Mahidol University
Tygerberg Hospital
Queen Sirikit National Institute of Child Health
All India Institute of Medical Sciences, New Delhi
Amrita Institute of Medical Sciences India
Universitäts-Kinderspital beider Basel
Universidade Federal Fluminense
Universiteit Stellenbosch
Postgraduate Institute of Medical Education & Research, Chandigarh
International Foundation Against Infectious Disease in Nigeria
Rural Development Trust Hospital
Cambodia Oxford Medical Research Unit
Phayao Hospital
Chiangrai Prachanukroh Hospital
Fernandez Hospital
Angkor Hospital for Children
Prontobaby Hospital da Criança
Keywords: Medicine
Issue Date: 1-Jan-2020
Citation: Archives of Disease in Childhood. Vol.105, No.1 (2020), 26-31
Abstract: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 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.
ISSN: 14682044
Appears in Collections:Scopus 2020

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