Neonatal Sepsis: Treatment of Neonatal Sepsis in Multidrug-Resistant (MDR) Infections: Part 2

Dudeja, Sankalp

doi:10.1007/s12098-019-03152-7

Cited by 12 publications

(16 citation statements)

References 12 publications

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“…accounts for 8-22% of blood culture positive neonatal sepsis and it is among top 3 Gramnegative organisms causing neonatal sepsis along with Klebsiella spp. and Escherichia coli [1, [10][11][12][13][14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…was noted to be higher among out-born neonates as compared to in-born neonates (91% vs. 82%) [ 10 , 17 ]. The rising AMR among common organisms causing neonatal sepsis (Gram-negative organisms, particularly Acinetobacter spp., Klebsiella spp., and E. coli ) led to the resurgence in usage of colistin in the last decade and is going to pose a formidable threat in years to come [ 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Various studies demonstrated that Acinetobacter spp. accounts for 8-22% of blood culture positive neonatal sepsis [1, [10][11][12][13][14][15][16][17][18][19][20] and is among top 3 Gram-negative organisms causing neonatal sepsis along with Klebsiella spp., and Escherichia coli [1, 10,17]. In the last decade, there is an increase in antimicrobial resistance (AMR) globally which can lead to increased morbidity, mortality, duration of hospital admission, and cost of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Acinetobacter Sepsis Among Out-born Neonates Admitted to Neonatal Unit in Pediatric Emergency of a Tertiary Care Hospital in North India

et al. 2020

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Objectives To study the clinical profile, complications, antibiotic resistance pattern, treatment, and outcome of out-born neonates with Acinetobacter spp. sepsis admitted in Pediatric emergency of a tertiary care hospital in North India. Methods In this subgroup analysis of a prospective study (conducted over 1 y, February 2018 through January 2019), neonates with Acinetobacter spp. sepsis were included. The data collection included demographic details, clinical features, pre-referral treatment, complications, antibiotic resistance pattern, treatment, and final outcome. Results Acinetobacter spp. accounted for 10.6% (43/406) of all isolates and 22.7% (43/189) of Gram-negative isolates. The median (IQR) age at presentation was 1 (1-2) d, 2/3rd were male, and 46.5% were preterm. All were admitted in peripheral hospitals before referral to authors' centre and all received intravenous antibiotics and fluids. The resistance to different antibiotics was: Ciprofloxacin 82%, cephalosporins 78-100%, amikacin 75%, pipercillin-tazobactum 62%, carbapenems 50-85%, chloramphenicol 83%, and tetracycline 50-60%. All isolates were sensitive to colistin. The survival rate was 37.2% (n = 16) and 62.8% (n = 27) had poor outcome [death and Left against medical advice (LAMA)]. Higher proportion of neonates with Acinetobacter sepsis had septic shock, multiorgan dysfunctional syndrome (MODS), and disseminated intravascular coagulation (DIC); and higher proportion required mechanical ventilation, vasoactive drugs, and had poor outcome compared to those with sepsis due to other organisms. Conclusions Acinetobacter spp. accounts for high burden of sepsis among out-born neonates and is associated with alarmingly high resistance to cephalosporins, fluroquinolones, aminoglycosides, pipercillin-tazobactum, tetracyclines, and carbapenems. Neonates with Acinetobacter spp. sepsis had higher rates of complications, requirement of mechanical ventilation and vasoactive drugs, and poor survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acinetobacter Sepsis Among Out-born Neonates Admitted to Neonatal Unit in Pediatric Emergency of a Tertiary Care Hospital in North India

et al. 2020

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“…"Neonatal Sepsis part 2: Treatment of Neonatal sepsis in MDRO infections" is contributed by Sankalp Dudeja and discusses all the possible therapeutic options in the background of multidrug resistance [7].…”

mentioning

confidence: 99%

Resistance to Antibacterial Agents: Foregone Conclusion - What's Next?

Wattal

Khardori

2019

Indian J Pediatr

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“…Berardi A. et al (2019) mentioned that LOS was significantly associated with prematurity in Italian and the most common causative organisms were coagulase-negative staphylococci, E. coli, Staphylococcus aureus and Enterobacteriaceae (18) . In India, Dudeja (2020) stated that in developing countries the more commonly encountered pathogens in causing neonatal sepsis were Gram-negative organisms represented by Acinetobacter and Klebsiella species, as well as E. coli (19) . In 2011, Stoll and coworkers stated that the most significant pathogen in preterm infants was E. coli (20) .…”

Section: Discussionmentioning

confidence: 99%

Causative Microorganisms and Antibiotics Susceptibility in Neonatal Sepsis at Neonatal Intensive Care Unit: A Longitudinal Study from Diyala Governorate in Iraq

2021

IJFMT

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Background: Neonatal sepsis is classified into two types, early-onset and late-onset sepsis, depending on the time of appearance of the clinical features of neonatal sepsis. Objective:We aim to detect the most common causative organisms of neonatal sepsis and to evaluate the corresponding antibiotics susceptibility in the Diyala governorate. Patients and Methods:We prospectively collected a convenient sample of 106 sepsis-proven neonates from the neonatal intensive care unit at Al-Batool teaching hospital. We assessed all cases based on clinical features, laboratory investigations, and demographics.Results: Late-onset neonatal sepsis was predominant (77.4%) among neonates, and it was significantly associated with neonatal prematurity and the mode of delivery at p-values of 0.03 and 0.045 respectively. Premature neonates and those who were the product of cesarean section were more prone to develop late-onset neonatal sepsis with a relative risk of 2.8 and 2.54 respectively. The most common causative microorganism of early-onset neonatal sepsis was found to be Escherichia coli in 45.8% of cases while those causing late-onset neonatal sepsis were mainly due to Gram-negative bacilli represented by Klebsiella pneumonia (46.3%) and Acinetobacter baumannii (24.4%). Multi-drug resistance was evident for most of the causative microorganisms. Conclusion:To recapitulate, late-onset sepsis appeared was more common among Iraqi neonates, and it was significantly associated with the neonate prematurity and C-section mode of delivery.

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Neonatal Sepsis: Treatment of Neonatal Sepsis in Multidrug-Resistant (MDR) Infections: Part 2

Cited by 12 publications

References 12 publications

Acinetobacter Sepsis Among Out-born Neonates Admitted to Neonatal Unit in Pediatric Emergency of a Tertiary Care Hospital in North India

Acinetobacter Sepsis Among Out-born Neonates Admitted to Neonatal Unit in Pediatric Emergency of a Tertiary Care Hospital in North India

Resistance to Antibacterial Agents: Foregone Conclusion - What's Next?

Causative Microorganisms and Antibiotics Susceptibility in Neonatal Sepsis at Neonatal Intensive Care Unit: A Longitudinal Study from Diyala Governorate in Iraq

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