Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

Topçuoğlu, Sevilay; Demirhan, Salih; Dinçer, Emre; Özalkaya, Elif; Karatekın, Güner

doi:10.3390/children9111642

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…In a study conducted in Türkiye, cases of early-onset neonatal sepsis were investigated and 27.6% (8 out of 29) of E. coli strains were found to be ESBL positive; all of these ESBL producers were susceptible to gentamicin. 20 A study investigating the epidemiology of culture-proven neonatal sepsis from Saudi Arabia reported that all isolated gram-negative and grampositive bacteria were susceptible to aminoglycoside antibiotics (amikacin and/or gentamicin) tested. 21 This retrospective, laboratory data-based study had some limitations.…”

Section: Discussionmentioning

confidence: 99%

Emergence of Drug-Resistant Pathogens in a Neonatal Intensive Care Unit

Aydınlı,

Sertel Şelale,

Kaya

2023

J Pediatr Infect Dis

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Objective Neonatal bloodstream infections (BSIs) due to drug-resistant pathogens are a major cause of neonatal morbidity and mortality. Unfortunately, data regarding the pathogens and their resistance profile are limited in developing countries. The aim of this study was to determine the bacteriological profile and antimicrobial susceptibility patterns in neonatal BSI at a university hospital in Türkiye. Methods Medical records of neonates with suspected sepsis were retrospectively reviewed during the study period (between January 1, 2018, and December 31, 2020) for demographic data, blood culture, and antimicrobial susceptibility test results. Results During the study period, 117 BSI episodes were encountered in 106 neonates. The most common pathogen isolated was Staphylococcus epidermidis (n = 86, 73.5%), followed by Klebsiella pneumoniae (n = 11, 9.4%). Methicillin resistance among staphylococci (77/93, 82.8%) and extended-spectrum beta-lactamase (ESBL) production among Enterobacterales (14/17, 82.4%) were common. Gentamicin resistance was detected in 70.1% (54/77) of methicillin-resistant staphylococci and 78.6% (11/14) of ESBL (+) Enterobacterales. Vancomycin and colistin resistance were not detected. Conclusion The high rate of resistant pathogens encountered in neonatal BSIs underline the importance of constant surveillance of the local pathogens and their antimicrobial susceptibility patterns, which is crucial for implementing appropriate therapy that could save lives and lower the burden of antimicrobial resistance.

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Section: Discussionmentioning

confidence: 99%

Emergence of Drug-Resistant Pathogens in a Neonatal Intensive Care Unit

Aydınlı,

Sertel Şelale,

Kaya

2023

J Pediatr Infect Dis

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“…Engorgement is swelling and distension of the breasts, usually in the early days of initiation of lactation, caused by vascular dilation as well as the arrival of the early milk, and the women may experience extreme fullness, tightness, and pain in the breasts. Additionally, the skin may appear shiny and stretched, and the breasts may feel warm to the touch 19 .…”

Section: Methodsmentioning

confidence: 99%

Breast problems and associated factors among lactating women in Northeast Ethiopia, 2022

Shitie,

Adimasu,

Tsegaye

et al. 2024

Sci Rep

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Breastfeeding is the cornerstone of child and maternal health. However, maternal breast problems during breastfeeding have been frequently reported as one of the reasons for early discontinuation of breastfeeding. Despite the importance of having knowledge on breast problems magnitude and its associated factors in the clinical practices and designing effective interventions, there is limited data on this topic. Therefore, this study aimed to assess the prevalence and associated factors of breast problem among postnatal lactating women in Legambo district, south wollo zone, North East Ethiopia, in 2022. A community-based cross sectional study was conducted among 610 lactating mothers in Legambo district. Multi-stage sampling was employed to select study participants. Interviewer administered, WHO B-R-E-A-S-T-Feeding, observational checklist and maternal self-reported breast problem questionnaires were used to collect the data. Epi-Data version 3.1 was used for data entry and export to SPSS version 25.0 for analysis. Descriptive statistics and bi-variable and multivariable analysis was carried out. On the multivariable logistic regression, variables with p-value < 0.5 were considered as they had statistically significant association with breast problem. The overall prevalence of breast problems among postnatal lactating women was 54.3% (95%, CI 49.3–59.3%). Primipara (AOR = 5.09; 95% CI 3.40–7.62), preterm infant (AOR = 2.12; 95% CI 1.22–3.66), home delivery (AOR = 3.67; 95% CI 1.62–8.30), ineffective breastfeeding techniques (AOR = 2.45; 95%CI 1.61–3.74), caesarean section delivery (AOR = 2.05;95%CI :1.15–3.64) and mixed type of feeding (AOR = 1.97:95%CI 1.34–2.89) were factors showed significant association. The prevalence of breast problems was 54.3%. Relevant factors related to an increase risks are being primipara, cesarean section delivery, home delivery, preterm birth, ineffective breastfeeding techniques and mixed type of feeding.

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Pragmatic physiologically-based pharmacokinetic modeling to support clinical implementation of optimized gentamicin dosing in term neonates and infants: proof-of-concept

de Hoop-Sommen,

van der Heijden,

Freriksen

et al. 2023

Front. Pediatr.

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IntroductionModeling and simulation can support dosing recommendations for clinical practice, but a simple framework is missing. In this proof-of-concept study, we aimed to develop neonatal and infant gentamicin dosing guidelines, supported by a pragmatic physiologically-based pharmacokinetic (PBPK) modeling approach and a decision framework for implementation.MethodsAn already existing PBPK model was verified with data of 87 adults, 485 children and 912 neonates, based on visual predictive checks and predicted-to-observed pharmacokinetic (PK) parameter ratios. After acceptance of the model, dosages now recommended by the Dutch Pediatric Formulary (DPF) were simulated, along with several alternative dosing scenarios, aiming for recommended peak (i.e., 8–12 mg/L for neonates and 15–20 mg/L for infants) and trough (i.e., <1 mg/L) levels. We then used a decision framework to weigh benefits and risks for implementation.ResultsThe PBPK model adequately described gentamicin PK. Simulations of current DPF dosages showed that the dosing interval for term neonates up to 6 weeks of age should be extended to 36–48 h to reach trough levels <1 mg/L. For infants, a 7.5 mg/kg/24 h dose will reach adequate peak levels. The benefits of these dose adaptations outweigh remaining uncertainties which can be minimized by routine drug monitoring.ConclusionWe used a PBPK model to show that current DPF dosages for gentamicin in term neonates and infants needed to be optimized. In the context of potential uncertainties, the risk-benefit analysis proved positive; the model-informed dose is ready for clinical implementation.

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Early-Onset Neonatal Sepsis in Turkey: A Single-Center 7-Year Experience in Etiology and Antibiotic Susceptibility

Cited by 3 publications

References 22 publications

Emergence of Drug-Resistant Pathogens in a Neonatal Intensive Care Unit

Emergence of Drug-Resistant Pathogens in a Neonatal Intensive Care Unit

Breast problems and associated factors among lactating women in Northeast Ethiopia, 2022

Pragmatic physiologically-based pharmacokinetic modeling to support clinical implementation of optimized gentamicin dosing in term neonates and infants: proof-of-concept

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