Pathogen Distribution and Antimicrobial Resistance of Early Onset Sepsis in Very Premature Infants: A Real-World Study

Ji, Hongyan; Yu, Yonghui; Huang, Lei; Kou, Yan; Liu, Xin; Li, Shina; Zhang, Yongfeng; Li, Zhongliang; Sun, Xuemei; Wang, Jing; Yang, Kejia; Zhou, Lian; Luo, Yao; Zhao, Guoying; Yang, Zhenying; Zhang, Xiao; Cui, Xiujie; Li, Jing; Wang, Ying; Shi, Jing; Chen, Weibing; Ma, Yanying; Zhao, Peng; Zhao, Riming; Zhou, Kun; Li, Binghui; Zhu, Renxia; Gao, Yanling; Zhou, Zhiyuan; Li, Huan; Dou, Jinlan; Li, Haiyan; Zhao, Changliang; Zhang, Bingjin; Wang, Xiaokang

doi:10.1007/s40121-022-00688-8

Cited by 3 publications

(5 citation statements)

References 43 publications

(44 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 26 , 42 , 43 In our study, no CREC strains were detected in EOS, which was consistent with research conducted in China in 2022. 33 The resistance rates to cefepime, cefotaxime, and ceftazidime were 37.23%, 50.00%, and 26.6%, respectively, and approximately 60% to fluoroquinolones in our study. According to multicenter study data, E. coli is also a major cause of bloodstream infections in China, with around 30% of the isolates showing resistance to ceftazidime, cefepime, and aztreonam, and nearly 50% resistant to fluoroquinolones.…”

Section: Discussionsupporting

confidence: 46%

“…14,29 Overall, 66.91% of the isolated Klebsiella pneumoniae strains were identified as CRKP, which was notably higher than in other similar studies. 14,27,30,33 Among the EOS Klebsiella pneumoniae strains, 79.31% were resistant to imipenem and meropenem, significantly higher than in LOS (66.36% and 63.64%, respectively). The high percentage of CRKP infections leads to prolonged hospital stays, increased healthcare costs, and elevated mortality rates.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, CoNS were isolated in 33.88% of EOS cases and 37.10% of LOS cases, which is relatively high compared to other studies. 25 , 32 , 33 This difference may be attributed to variations in the definitions of CoNS sepsis and the challenges associated with distinguishing between true infections and contaminations. 34 However, with the continuous progress and widespread use of invasive diagnostic techniques in recent years, invasive infections caused by CoNS have received increasing attention.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

Fang¹,

Gao²,

Yang³

et al. 2023

IDR

View full text Add to dashboard Cite

Introduction Sepsis is the most severe infectious disease with the highest mortality rate, particularly among neonates admitted to the neonatal intensive care unit (NICU). This study retrospectively analyzed the epidemiology, antibiotic resistance profiles, and prevalence of multidrug-resistant (MDR) bacteria isolated from blood or cerebrospinal fluid (CSF) cultures in order to evaluate the appropriateness of initial empirical therapy for neonatal sepsis. Methods A retrospective study was conducted in the NICU from January 1, 2015, to December 31, 2022. Microbiological data from patients admitted to the NICU were anonymously extracted from the Laboratory of Microbiology database. Neonatal sepsis was classified into two types: early-onset sepsis (EOS), which occurs within the first 72 hours of life, and late-onset sepsis (LOS) for those begins later. Results A total of 679 bacterial strains, 543 from blood and 136 from CSF, were detected in 631 neonates. Among these, 378 isolates (55.67%) were Gram-positive bacteria, and 301 isolates (44.33%) were Gram-negative bacteria. The most frequently isolated pathogens were Coagulase-negative staphylococci (CoNS) (36.52%), followed by Klebsiella pneumoniae (20.47%) and Escherichia coli (13.84%). In EOS, 121 strains were found, CoNS represented the majority (33.88%), followed by Klebsiella pneumoniae (23.97%) and Escherichia coli (8.26%). Early-onset septicemia exhibited 67 (55.37%) MDR bacteria. In LOS, 558 strains were isolated, CoNS represented the majority of pathogens (37.10%), followed by Klebsiella pneumoniae (19.71%) and Escherichia coli (15.05%). Late-onset septicemia showed 332 (59.50%) MDR bacteria. High rates of MDR were found in CoNS (76.21%), carbapenem-resistant Klebsiella pneumoniae (66.91%), and MRSA (33.33%). Conclusion The study revealed an alarming prevalence of MDR strains isolated from neonatal sepsis, emphasizing the necessity of finding effective prevention and treatment measures. Colistin can be used for MDR Gram-negative bacteria, while vancomycin and teicoplanin can be considered treatment therapies for staphylococcal infections.

show abstract

Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

Fang¹,

Gao²,

Yang³

et al. 2023

IDR

View full text Add to dashboard Cite

show abstract

“…Studies, based on data from the Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) network also proved the leading role of Klebsiella spp., especially Klebsiella pneumoniae in NS [ 11 , 12 , 13 ]. In very preterm infants with EOS, in the framework of the BARNERDS network, the main pathogen was E. coli [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among causative agents of EOS in very preterm infants 60.6% of E. coli isolates and 42.9% of Klebsiella spp. were multidrug resistant [ 14 ]. Increased rates of antibiotic resistance lead to the use of antibiotics by Watch and Reserve groups (World Health Organization classification), which may result in decreased safety profile.…”

Section: Introductionmentioning

confidence: 99%

Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants

et al. 2023

View full text Add to dashboard Cite

Neonatal Infections are among the most common reasons for admission to the intensive care unit. Neonatal sepsis (NS) significantly contributes to mortality rates. Empiric antibiotic therapy of NS recommended by current international guidelines includes benzylpenicillin, ampicillin/amoxicillin, and aminoglycosides (gentamicin). The rise of antibacterial resistance precipitates the growth of the use of antibiotics of the Watch (second, third, and fourth generations of cephalosporines, carbapenems, macrolides, glycopeptides, rifamycins, fluoroquinolones) and Reserve groups (fifth generation of cephalosporines, oxazolidinones, lipoglycopeptides, fosfomycin), which are associated with a less clinical experience and higher risks of toxic reactions. A proper dosing regimen is essential for effective and safe antibiotic therapy, but its choice in neonates is complicated with high variability in the maturation of organ systems affecting drug absorption, distribution, metabolism, and excretion. Changes in antibiotic pharmacokinetic parameters result in altered efficacy and safety. Population pharmacokinetics can help to prognosis outcomes of antibiotic therapy, but it should be considered that the neonatal population is heterogeneous, and this heterogeneity is mainly determined by gestational and postnatal age. Preterm neonates are common in clinical practice, and due to the different physiology compared to the full terms, constitute a specific neonatal subpopulation. The objective of this review is to summarize the evidence about the developmental changes (specific for preterm and full-term infants, separately) of pharmacokinetic parameters of antibiotics used in neonatal intensive care units.

show abstract

Neonatal Early-Onset Sepsis

Flannery,

Ramachandran,

Schrag

2024

Clinics in Perinatology

View full text Add to dashboard Cite

Pathogen Distribution and Antimicrobial Resistance of Early Onset Sepsis in Very Premature Infants: A Real-World Study

Cited by 3 publications

References 43 publications

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

Prevalence of Multidrug-Resistant Pathogens Causing Neonatal Early and Late Onset Sepsis, a Retrospective Study from the Tertiary Referral Children’s Hospital

Developmental Pharmacokinetics of Antibiotics Used in Neonatal ICU: Focus on Preterm Infants

Neonatal Early-Onset Sepsis

Contact Info

Product

Resources

About