Epidemiology of infections and antimicrobial use in Greek Neonatal Units. Issue 3 (28th May 2019)

• Record Type: Journal Article
• Authors: Gkentzi, Despoina; Kortsalioudaki, Christina; Cailes, Benjamin Campbell; Zaoutis, Theoklis; Kopsidas, John; Tsolia, Maria; Spyridis, Nikos; Siahanidou, Soultana; Sarafidis, Kosmas; Heath, Paul T; Dimitriou, Gabriel
• Other Names: author non-byline.; Karachristou Korina author non-byline.; Bouza Eleni author non-byline.; Lipsou Niki author non-byline.; Anatolitou Fani author non-byline.; Stratiki Zelina author non-byline.; Baroutis Georgios author non-byline.; Nyktari Georgia author non-byline.; Peristeri Vassiliki author non-byline.; Lithoxopoulou Maria author non-byline.; Charitou Antonia author non-byline.; Spanopoulou Ioanna author non-byline.; Manoura Antonia author non-byline.; Skordala Marianna author non-byline.; Giapros Basilis author non-byline.; Agakidou-drossou Vassiliki author non-byline.; Tzaki Margarita author non-byline.; Michalodimitraki Lida author non-byline.; Mavrogeorgos Georgios author non-byline.; Avgeri Aikaterini author non-byline.
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 3(2019)
• Page Start: F293
• Publication Date: 2019-05-28
• Subjects: neonatal infections -- greece -- epidemiology -- antimicrobial use; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2018-315024
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: To describe the epidemiology of neonatal infections and of antimicrobial use in Greek Neonatal Units (NNUs) in order to develop national, evidence-based guidelines on empiric antimicrobial use for neonatal sepsis in Greece. Design: Retrospective analysis of prospectively collected infection surveillance data from 2012 to 2015, together with a Point Prevalence Survey (PPS) on antimicrobial use and the collection of data on local empiric antimicrobial policies. Setting: 16 NNUs in Greece participating in the neonIN infection surveillance network Patients: Newborns in participating NNUs who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of antibiotics. Results: 459 episodes were recorded in 418 infants. The overall incidence of infection was 50/1000 NNU-admissions. The majority of episodes were late-onset sepsis (LOS) (413, 90%). Coagulase-negative Staphylococci (80%) were the most common Gram-positive organisms causing LOS and Klebsiella spp (39%) the most common Gram-negative. Nearly half (45%) of the Klebsiella spp were resistant to at least one aminoglycoside. The PPS revealed that 196 of 484 (40%) neonates were on antimicrobials. The survey revealed wide variation in empiric antimicrobial policies for LOS. Conclusions: This is the largest collection of data on the epidemiology of neonatal infections in Greece and on neonatal antimicrobial use. It provides the background for the development of national evidence-based guidelines. Continuous surveillance, the introduction of antimicrobial stewardship interventions and evidence-based guidelines are urgently required.