Antimicrobial resistance in UK neonatal units: neonIN infection surveillance network

Arch Dis Child Fetal Neonatal Ed. 2018 Sep;103(5):F474-F478. doi: 10.1136/archdischild-2017-313238. Epub 2017 Oct 26.

Abstract

Objective: To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK.

Design: Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014.

Setting: 30 neonatal units in the UK.

Patients: Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics.

Results: 1568 isolates with recorded antimicrobial data were collected including 328 early-onset sepsis (EOS) isolates and 1240 late-onset sepsis (LOS) isolates. The majority of EOS pathogens (>92%) were susceptible to the four empirical commonly used antimicrobial combinations (eg, 93% for benzylpenicillin/gentamicin), while LOS pathogens demonstrated higher levels of resistance (eg, 89% for flucloxacillin/gentamicin). Among infants<1500 g and <32 weeks gestation, an amoxicillin/gentamicin combination demonstrated a trend towards improved coverage of EOS isolates than benzylpenicillin/gentamicin (93% vs 86%, p=0.211).

Conclusions: This analysis provides insights into the patterns of antimicrobial resistance among UK neonatal pathogens. These data will inform areas of future research and can be used to update national evidence-based guidelines on antimicrobial usage.

Keywords: epidemiology; infectious diseases; intensive care; neonatology.

MeSH terms

  • Anti-Bacterial Agents* / classification
  • Anti-Bacterial Agents* / therapeutic use
  • Bacteria* / classification
  • Bacteria* / drug effects
  • Bacteria* / isolation & purification
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination / methods
  • Drug Therapy, Combination / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • Infection Control* / methods
  • Infection Control* / organization & administration
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Male
  • Microbial Sensitivity Tests / methods
  • Neonatal Sepsis* / diagnosis
  • Neonatal Sepsis* / drug therapy
  • Neonatal Sepsis* / epidemiology
  • Neonatal Sepsis* / microbiology
  • Retrospective Studies
  • United Kingdom / epidemiology

Substances

  • Anti-Bacterial Agents