Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study
Neonatal sepsis is an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Continuous evaluation of antimicrobial resistance (AMR) profiles is advised to implement antimicrobial stewardship (AMS) programs and establish effective empiric antibiotic protocols. AMS may r...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/10/1488 |
| _version_ | 1797574967340040192 |
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| author | Chiara Minotti Antonella Di Caprio Laura Facchini Luca Bedetti Francesca Miselli Cecilia Rossi Elisa Della Casa Muttini Licia Lugli Laura Luppi Filippo Ferrari Alberto Berardi |
| author_facet | Chiara Minotti Antonella Di Caprio Laura Facchini Luca Bedetti Francesca Miselli Cecilia Rossi Elisa Della Casa Muttini Licia Lugli Laura Luppi Filippo Ferrari Alberto Berardi |
| author_sort | Chiara Minotti |
| collection | DOAJ |
| description | Neonatal sepsis is an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Continuous evaluation of antimicrobial resistance (AMR) profiles is advised to implement antimicrobial stewardship (AMS) programs and establish effective empiric antibiotic protocols. AMS may reduce AMR in NICUs and improve sepsis outcomes. In this retrospective observational study, we report data on culture-positive neonatal sepsis, assessing differences after the implementation of an AMS program (2011–2016 vs. 2017–2022). A total of 215 positive bacterial cultures from 169 infants were retrieved, with 79 early-onset (36.7%) and 136 late-onset (63.3%) sepsis episodes. Frequent causative agents for early-onset sepsis were <i>S. agalactiae</i> and <i>E. coli</i>, all susceptible to empiric treatment. Late-onset sepsis was mainly caused by <i>Enterobacterales</i> and <i>S. aureus</i>. Aminoglycosides, cefotaxime, and piperacillin-tazobactam resistance among <i>Enterobacterales</i> was substantially low; <i>S. aureus</i> was mostly susceptible to oxacillin and vancomycin. There were no differences in mortality and multidrug-resistant pathogens rates between the two study periods. There were five episodes of fungal late-onset sepsis, mostly due to <i>C. albicans</i>, of which one was fatal. The microbial distribution pattern and AMR profiles overlapped with other European studies. Because susceptibility patterns are rapidly changing worldwide, with the emerging threat of Methicillin-resistant <i>S. aureus</i> and extended-spectrum beta-lactamases producers, infection prevention and control practices and AMS strategies require continuous optimization to limit selection pressure and AMR escalation. |
| first_indexed | 2024-03-10T21:29:39Z |
| format | Article |
| id | doaj.art-b50ea0fd089a476cb82788fbcdd308c6 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T21:29:39Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b50ea0fd089a476cb82788fbcdd308c62023-11-19T15:26:11ZengMDPI AGAntibiotics2079-63822023-09-011210148810.3390/antibiotics12101488Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year StudyChiara Minotti0Antonella Di Caprio1Laura Facchini2Luca Bedetti3Francesca Miselli4Cecilia Rossi5Elisa Della Casa Muttini6Licia Lugli7Laura Luppi8Filippo Ferrari9Alberto Berardi10Neonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyClinical Microbiology Unit, University Hospital of Modena, 41124 Modena, ItalyClinical Microbiology Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal Intensive Care Unit, University Hospital of Modena, 41124 Modena, ItalyNeonatal sepsis is an important cause of morbidity and mortality in neonatal intensive care units (NICUs). Continuous evaluation of antimicrobial resistance (AMR) profiles is advised to implement antimicrobial stewardship (AMS) programs and establish effective empiric antibiotic protocols. AMS may reduce AMR in NICUs and improve sepsis outcomes. In this retrospective observational study, we report data on culture-positive neonatal sepsis, assessing differences after the implementation of an AMS program (2011–2016 vs. 2017–2022). A total of 215 positive bacterial cultures from 169 infants were retrieved, with 79 early-onset (36.7%) and 136 late-onset (63.3%) sepsis episodes. Frequent causative agents for early-onset sepsis were <i>S. agalactiae</i> and <i>E. coli</i>, all susceptible to empiric treatment. Late-onset sepsis was mainly caused by <i>Enterobacterales</i> and <i>S. aureus</i>. Aminoglycosides, cefotaxime, and piperacillin-tazobactam resistance among <i>Enterobacterales</i> was substantially low; <i>S. aureus</i> was mostly susceptible to oxacillin and vancomycin. There were no differences in mortality and multidrug-resistant pathogens rates between the two study periods. There were five episodes of fungal late-onset sepsis, mostly due to <i>C. albicans</i>, of which one was fatal. The microbial distribution pattern and AMR profiles overlapped with other European studies. Because susceptibility patterns are rapidly changing worldwide, with the emerging threat of Methicillin-resistant <i>S. aureus</i> and extended-spectrum beta-lactamases producers, infection prevention and control practices and AMS strategies require continuous optimization to limit selection pressure and AMR escalation.https://www.mdpi.com/2079-6382/12/10/1488antimicrobial stewardshipneonatal infectionneonatal sepsisinfection prevention and controlantimicrobial resistance |
| spellingShingle | Chiara Minotti Antonella Di Caprio Laura Facchini Luca Bedetti Francesca Miselli Cecilia Rossi Elisa Della Casa Muttini Licia Lugli Laura Luppi Filippo Ferrari Alberto Berardi Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study Antibiotics antimicrobial stewardship neonatal infection neonatal sepsis infection prevention and control antimicrobial resistance |
| title | Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study |
| title_full | Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study |
| title_fullStr | Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study |
| title_full_unstemmed | Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study |
| title_short | Antimicrobial Resistance Pattern and Empirical Antibiotic Treatments in Neonatal Sepsis: A Retrospective, Single-Center, 12-Year Study |
| title_sort | antimicrobial resistance pattern and empirical antibiotic treatments in neonatal sepsis a retrospective single center 12 year study |
| topic | antimicrobial stewardship neonatal infection neonatal sepsis infection prevention and control antimicrobial resistance |
| url | https://www.mdpi.com/2079-6382/12/10/1488 |
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