Late-onset neonatal sepsis in Suzhou, China

Pan, Tao; Zhu, Qiujiao; Li, Pei; Hua, Jing; Feng, Xing

doi:10.1186/s12887-020-02103-y

Cited by 15 publications

(11 citation statements)

References 34 publications

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“…However, domestic reality makes this value improper. In China, the predominant Gram-negative pathogens responsible for LOS are E. coli and K. pneumoniae [ 3 , 10 ]. Recent efforts suggest that E. coli is susceptible to carbapenem antibiotics in China, with a resistance rate less than 5%.…”

Section: Discussionmentioning

confidence: 99%

“…Neonatal sepsis is a worldwide burden with substantial morbidity. Late-onset sepsis (LOS), mainly occurring more than 72 h after birth, has a high mortality rate (5–15%) [ 1 , 2 , 3 ]. A meropenem dose of 10–40 mg/kg is commonly prescribed in neonates and young infants, although its use is not licensed for those under three months of age [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The causative pathogens outside of China are relatively diverse and susceptible to meropenem with a lower minimal inhibitory concentration (MIC) breakpoint (<2 mg/L) [ 8 ]. In China, Escherichia coli ( E. coli ) and Klebsiella pneumoniae ( K. pneumoniae ) are the primary Gram-negative bacteria responsible for LOS, and the latter causes the most deaths [ 3 , 9 , 10 , 11 ]. The data from the Chinese antimicrobial resistance surveillance network show, between 2005 and 2017, that the proportion of meropenem-resistant K. pneumoniae increases from 2.9% to 24.0% [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis

Kou

et al. 2022

Children

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The pharmacokinetic (PK) studies of meropenem in Chinese newborns with late-onset sepsis (LOS) are still lacking. Causative pathogens of LOS and their susceptibility patterns in China differ from the data abroad. We, therefore, conducted a developmental population pharmacokinetic–pharmacodynamic analysis in Chinese newborns with the goal to optimize meropenem dosing regimens for LOS therapy. An opportunistic sampling strategy was used to collect meropenem samples, followed by model building and validation. A Monte Carlo simulation was performed to show the probability of target attainment (PTA) for various dosages. The information from 78 newborns (postmenstrual age: 27.4–46.1 weeks) was compiled and had a good fit to a 1-compartment model that had first order elimination. The median (range) values of estimated weight–normalized volume of distribution (V)and clearance (CL) were 0.60 (0.51–0.69) L/kg and 0.16 (0.04–0.51) L/h/kg, respectively. Covariate analysis revealed that postnatal age (PNA), gestational age (GA) and current weight (CW) were the most important factors in describing meropenem PK. Simulation results showed for LOS with a minimal inhibitory concentration (MIC) of 8 mg/L, the doses of 30 mg/kg 3 times daily (TID) as a 1-h infusion for newborns with GA ≤ 37 weeks and 40 mg/kg TID as a 3-h infusion for those with GA > 37 weeks were optimal, with PTA of 71.71% and 75.08%, respectively. In conclusion, we proposed an evidence-based dosing regimen of meropenem for LOS in Chinese newborns by using the population pharmacokinetic–pharmacodynamic analysis, based on domestic common pathogens and their susceptibility patterns.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis

Kou

et al. 2022

Children

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“…1,[8][9][10] E. coli plays an important role in causing both early-onset sepsis (EOS) and late-onset sepsis (LOS). 3,[6][7][8][11][12][13][14] E. coli is also one of the most common pathogenic bacteria causing neonatal bacterial meningitis. [15][16][17] Neonate with E. coli meningitis can have adverse nervous system sequelae, which is an important cause of poor long-term prognosis of newborns with E. coli sepsis.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Zhu¹,

Wang²,

Zhuge³

et al. 2023

IDR

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Background and Objective: An increasing number of cases of neonatal sepsis due to extended-spectrum beta-lactamase (ESBL)producing multi-drug resistant (MDR) Escherichia coli (E. coli) have been reported worldwide. The aim of this study was to explore the risk factors associated with ESBL-producing MDR E. coli among neonates with culture-confirmed E. coli sepsis and thereby to help selection of appropriate empirical antibiotics. Patients and Methods: All newborn infants with a confirmed pathogen isolated from blood or cerebrospinal fluid (CSF) from 2016 to 2021 were identified and those with E. coli infection were included in this analysis. We compared a group of neonatal patients with ESBL-producing MDR E. coli sepsis (n=69) to a group with ESBL-negative E. coli (n=70) based on antimicrobial susceptibility reports. We used multivariable regression analysis to determine the risk factors associated with ESBL-producing MDR E. coli strains among the neonates with culture-confirmed E. coli sepsis. Results: ESBL-producing MDR E. coli sepsis was more common in premature infants and newborns with hospital-acquired late-onset sepsis (HALOS). The mortality rate of neonatal sepsis caused by ESBL-producing E. coli was about twice as that of sepsis caused by ESBL-negative E. coli. Antepartum exposure to cephalosporins (OR=25.191, P<0.01) and parenteral nutrition for more than 1 week (OR=4.495, 95% CI: 2.009-10.055, P<0.01) were independent risk factors for neonatal infection with ESBL-producing stains among infants with E. coli sepsis. Conclusion: E. coli remains the most common Gram-negative bacterial pathogen causing neonatal sepsis. A higher proportion of ESBLproducing MDR E. coli is seen in premature infants and those newborns with HALOS and is associated with higher mortality. Antepartum use of cephalosporins and prolonged use of parenteral nutrition may be important factors to consider in the selection of empirical antibiotics for use in neonatal sepsis caused by gram-negative rods prior to the availability of the results of antimicrobial susceptibility.

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“…IT ratio of more than 0.2 was considered as a case of sepsis. Procalcitonin more than 0.45 was considered as a case of sepsis [3,[17][18]. In our study, we found IT ratio mean is about 0.5 with range 0.01 -11.…”

Section: Discussionmentioning

confidence: 61%

Characteristics of neonatal late onset sepsis in Sanglah Hospital, Bali

Prayoga¹,

Kardana²,

Artana³

et al. 2021

GSC Adv. Res. Rev.

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Neonatal Late-Onset Sepsis (LOS) is a leading cause of mortality in the Neonatal Intensive Care Unit (NICU). The microbial characteristics of LOS are of primary importance in guiding clinical antisepsis practice, and strategies to prevent and treat neonatal LOS, in turn, influence the pattern of LOS pathogens. This study is a retrospective descriptive study with a cross-sectional approach conducted between 2016 until 2020 in the neonatal ward (level II-III) of the Sanglah General Hospital, Bali. Data collected consists of demography, clinical characteristics, laboratory results, and outcomes. Subjects in this study dominated by male (64%), gestational age > 37 weeks (56%), born ≥ 2.500 grams (54%), last mother education mostly in Senior High School (56%), spontaneous delivery method (54%) and 31 (62%) subjects were referral from other hospital and primary health care. Most of the subjects were lethargic (68%) and 15 (30%) subjects were died. Laboratory finding normal leukocyte, neutrophil, lymphocyte, hemoglobin, thrombocyte and IT ratio but have higher procalcitonin result. Poor outcome group were dominated by male, smaller gestational age, VLBW, and neonates who experience lethargy, temperature instability, respiratory distress and got positive blood culture.

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Late-onset neonatal sepsis in Suzhou, China

Cited by 15 publications

References 34 publications

Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis

Developmental Population Pharmacokinetics-Pharmacodynamics of Meropenem in Chinese Neonates and Young Infants: Dosing Recommendations for Late-Onset Sepsis

Risk Factors Associated with Multi-Drug Resistance in Neonatal Sepsis Caused by Escherichia coli

Characteristics of neonatal late onset sepsis in Sanglah Hospital, Bali

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