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1. Assessment of three antibiotic combination regimens against Gram-negative bacteria causing neonatal sepsis in low- and middle-income countries

Author

Kakaraskoska Boceska, Biljana, Vilken, Tuba, Xavier, Basil Britto, Kostyanev, Tomislav, Lin, Qiang, Lammens, Christine, Ellis, Sally, O’Brien, Seamus, da Costa, Renata Maria Augusto, Cook, Aislinn, Russell, Neal, Bielicki, Julia, Riddell, Amy, Stohr, Wolfgang, Walker, Ann Sarah, Berezin, Eitan Naaman, Roilides, Emmanuel, De Luca, Maia, Romani, Lorenza, Ballot, Daynia, Dramowski, Angela, Wadula, Jeannette, Lochindarat, Sorasak, Boonkasidecha, Suppawat, Namiiro, Flavia, Ngoc, Hoang Thi Bich, Tran, Minh Dien, Cressey, Tim R., Preedisripipat, Kanchana, Berkley, James A., Musyimi, Robert, Zarras, Charalampos, Nana, Trusha, Whitelaw, Andrew, da Silva, Cely Barreto, Jaglal, Prenika, Ssengooba, Willy, Saha, Samir K., Islam, Mohammad Shahidul, Mussi-Pinhata, Marisa Marcia, Carvalheiro, Cristina Gardonyi, Piddock, Laura J. V., Heath, Paul T., Malhotra-Kumar, Surbhi, Sharland, Michael, Glupczynski, Youri, and Goossens, Herman

Published
2024
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5. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis

Author

Murray, Christopher J L, Ikuta, Kevin Shunji, Sharara, Fablina, Swetschinski, Lucien, Robles Aguilar, Gisela, Gray, Authia, Han, Chieh, Bisignano, Catherine, Rao, Puja, Wool, Eve, Johnson, Sarah C, Browne, Annie J, Chipeta, Michael Give, Fell, Frederick, Hackett, Sean, Haines-Woodhouse, Georgina, Kashef Hamadani, Bahar H, Kumaran, Emmanuelle A P, McManigal, Barney, Achalapong, Sureeruk, Agarwal, Ramesh, Akech, Samuel, Albertson, Samuel, Amuasi, John, Andrews, Jason, Aravkin, Aleskandr, Ashley, Elizabeth, Babin, François-Xavier, Bailey, Freddie, Baker, Stephen, Basnyat, Buddha, Bekker, Adrie, Bender, Rose, Berkley, James A, Bethou, Adhisivam, Bielicki, Julia, Boonkasidecha, Suppawat, Bukosia, James, Carvalheiro, Cristina, Castañeda-Orjuela, Carlos, Chansamouth, Vilada, Chaurasia, Suman, Chiurchiù, Sara, Chowdhury, Fazle, Clotaire Donatien, Rafai, Cook, Aislinn J, Cooper, Ben, Cressey, Tim R, Criollo-Mora, Elia, Cunningham, Matthew, Darboe, Saffiatou, Day, Nicholas P J, De Luca, Maia, Dokova, Klara, Dramowski, Angela, Dunachie, Susanna J, Duong Bich, Thuy, Eckmanns, Tim, Eibach, Daniel, Emami, Amir, Feasey, Nicholas, Fisher-Pearson, Natasha, Forrest, Karen, Garcia, Coralith, Garrett, Denise, Gastmeier, Petra, Giref, Ababi Zergaw, Greer, Rachel Claire, Gupta, Vikas, Haller, Sebastian, Haselbeck, Andrea, Hay, Simon I, Holm, Marianne, Hopkins, Susan, Hsia, Yingfen, Iregbu, Kenneth C, Jacobs, Jan, Jarovsky, Daniel, Javanmardi, Fatemeh, Jenney, Adam W J, Khorana, Meera, Khusuwan, Suwimon, Kissoon, Niranjan, Kobeissi, Elsa, Kostyanev, Tomislav, Krapp, Fiorella, Krumkamp, Ralf, Kumar, Ajay, Kyu, Hmwe Hmwe, Lim, Cherry, Lim, Kruy, Limmathurotsakul, Direk, Loftus, Michael James, Lunn, Miles, Ma, Jianing, Manoharan, Anand, Marks, Florian, May, Jürgen, Mayxay, Mayfong, Mturi, Neema, Munera-Huertas, Tatiana, Musicha, Patrick, Musila, Lilian A, Mussi-Pinhata, Marisa Marcia, Naidu, Ravi Narayan, Nakamura, Tomoka, Nanavati, Ruchi, Nangia, Sushma, Newton, Paul, Ngoun, Chanpheaktra, Novotney, Amanda, Nwakanma, Davis, Obiero, Christina W, Ochoa, Theresa J, Olivas-Martinez, Antonio, Olliaro, Piero, Ooko, Ednah, Ortiz-Brizuela, Edgar, Ounchanum, Pradthana, Pak, Gideok D, Paredes, Jose Luis, Peleg, Anton Yariv, Perrone, Carlo, Phe, Thong, Phommasone, Koukeo, Plakkal, Nishad, Ponce-de-Leon, Alfredo, Raad, Mathieu, Ramdin, Tanusha, Rattanavong, Sayaphet, Riddell, Amy, Roberts, Tamalee, Robotham, Julie Victoria, Roca, Anna, Rosenthal, Victor Daniel, Rudd, Kristina E, Russell, Neal, Sader, Helio S, Saengchan, Weerawut, Schnall, Jesse, Scott, John Anthony Gerard, Seekaew, Samroeng, Sharland, Mike, Shivamallappa, Madhusudhan, Sifuentes-Osornio, Jose, Simpson, Andrew J, Steenkeste, Nicolas, Stewardson, Andrew James, Stoeva, Temenuga, Tasak, Nidanuch, Thaiprakong, Areerat, Thwaites, Guy, Tigoi, Caroline, Turner, Claudia, Turner, Paul, van Doorn, H Rogier, Velaphi, Sithembiso, Vongpradith, Avina, Vongsouvath, Manivanh, Vu, Huong, Walsh, Timothy, Walson, Judd L, Waner, Seymour, Wangrangsimakul, Tri, Wannapinij, Prapass, Wozniak, Teresa, Young Sharma, Tracey E M W, Yu, Kalvin C, Zheng, Peng, Sartorius, Benn, Lopez, Alan D, Stergachis, Andy, Moore, Catrin, Dolecek, Christiane, and Naghavi, Mohsen

Published
2022
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6. Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS)

Author

Russell, Neal J., Stöhr, Wolfgang, Plakkal, Nishad, Cook, Aislinn, Berkley, James A., Adhisivam, Bethou, Agarwal, Ramesh, Ahmed, Nawshad Uddin, Balasegaram, Manica, Ballot, Daynia, Bekker, Adrie, Berezin, Eitan Naaman, Bilardi, Davide, Boonkasidecha, Suppawat, Carvalheiro, Cristina G., Chami, Neema, Chaurasia, Suman, Chiurchiu, Sara, Colas, Viviane Rinaldi Favarin, Cousens, Simon, Cressey, Tim R., de Assis, Ana Carolina Dantas, Dien, Tran Minh, Ding, Yijun, Dung, Nguyen Trong, Dong, Han, Dramowski, Angela, DS, Madhusudhan, Dudeja, Ajay, Feng, Jinxing, Glupczynski, Youri, Goel, Srishti, Goossens, Herman, Hao, Doan Thi Huong, Khan, Mahmudul Islam, Huertas, Tatiana Munera, Islam, Mohammad Shahidul, Jarovsky, Daniel, Khavessian, Nathalie, Khorana, Meera, Kontou, Angeliki, Kostyanev, Tomislav, Laoyookhon, Premsak, Lochindarat, Sorasak, Larsson, Mattias, Luca, Maia De, Malhotra-Kumar, Surbhi, Mondal, Nivedita, Mundhra, Nitu, Musoke, Philippa, Mussi-Pinhata, Marisa M., Nanavati, Ruchi, Nakwa, Firdose, Nangia, Sushma, Nankunda, Jolly, Nardone, Alessandra, Nyaoke, Borna, Obiero, Christina W., Owor, Maxensia, Ping, Wang, Preedisripipat, Kanchana, Qazi, Shamim, Qi, Lifeng, Ramdin, Tanusha, Riddell, Amy, Romani, Lorenza, Roysuwan, Praewpan, Saggers, Robin, Roilides, Emmanuel, Saha, Samir K., Sarafidis, Kosmas, Tusubira, Valerie, Thomas, Reenu, Velaphi, Sithembiso, Vilken, Tuba, Wang, Xiaojiao, Wang, Yajuan, Yang, Yonghong, Zunjie, Liu, Ellis, Sally, Bielicki, Julia A., Walker, A. Sarah, Heath, Paul T., and Sharland, Mike

Subjects
Infants -- Patient outcomes, Sepsis -- Diagnosis -- Care and treatment, Antibiotics -- Dosage and administration, Hospital patients -- Care and treatment, Market trend/market analysis, Biological sciences
Abstract

Background There is limited data on antibiotic treatment in hospitalized neonates in low- and middle-income countries (LMICs). We aimed to describe patterns of antibiotic use, pathogens, and clinical outcomes, and to develop a severity score predicting mortality in neonatal sepsis to inform future clinical trial design. Methods and findings Hospitalized infants A total of 3,204 infants were enrolled, with median birth weight of 2,500 g (IQR 1,400 to 3,000) and postnatal age of 5 days (IQR 1 to 15). 206 different empiric antibiotic combinations were started in 3,141 infants, which were structured into 5 groups based on the World Health Organization (WHO) AWaRe classification. Approximately 25.9% (n = 814) of infants started WHO first line regimens (Group 1-Access) and 13.8% (n = 432) started WHO second-line cephalosporins (cefotaxime/ceftriaxone) (Group 2-'Low' Watch). The largest group (34.0%, n = 1,068) started a regimen providing partial extended-spectrum beta-lactamase (ESBL)/pseudomonal coverage (piperacillin-tazobactam, ceftazidime, or fluoroquinolone-based) (Group 3-'Medium' Watch), 18.0% (n = 566) started a carbapenem (Group 4-'High' Watch), and 1.8% (n = 57) a Reserve antibiotic (Group 5, largely colistin-based), and 728/2,880 (25.3%) of initial regimens in Groups 1 to 4 were escalated, mainly to carbapenems, usually for clinical deterioration (n = 480; 65.9%). A total of 564/3,195 infants (17.7%) were blood culture pathogen positive, of whom 62.9% (n = 355) had a gram-negative organism, predominantly Klebsiella pneumoniae (n = 132) or Acinetobacter spp. (n = 72). Both were commonly resistant to WHO-recommended regimens and to carbapenems in 43 (32.6%) and 50 (71.4%) of cases, respectively. MRSA accounted for 33 (61.1%) of 54 Staphylococcus aureus isolates. Overall, 350/3,204 infants died (11.3%; 95% CI 10.2% to 12.5%), 17.7% if blood cultures were positive for pathogens (95% CI 14.7% to 21.1%, n = 99/564). A baseline NeoSep Severity Score had a C-index of 0.76 (0.69 to 0.82) in the validation sample, with mortality of 1.6% (3/189; 95% CI: 0.5% to 4.6%), 11.0% (27/245; 7.7% to 15.6%), and 27.3% (12/44; 16.3% to 41.8%) in low (score 0 to 4), medium (5 to 8), and high (9 to 16) risk groups, respectively, with similar performance across subgroups. A related NeoSep Recovery Score had an area under the receiver operating curve for predicting death the next day between 0.8 and 0.9 over the first week. There was significant variation in outcomes between sites and external validation would strengthen score applicability. Conclusion Antibiotic regimens used in neonatal sepsis commonly diverge from WHO guidelines, and trials of novel empiric regimens are urgently needed in the context of increasing antimicrobial resistance (AMR). The baseline NeoSep Severity Score identifies high mortality risk criteria for trial entry, while the NeoSep Recovery Score can help guide decisions on regimen change. NeoOBS data informed the NeoSep1 antibiotic trial (ISRCTN48721236), which aims to identify novel first- and second-line empiric antibiotic regimens for neonatal sepsis. Trial registration ClinicalTrials.gov, (NCT03721302)., Author(s): Neal J. Russell 1,*, Wolfgang Stöhr 2, Nishad Plakkal 3, Aislinn Cook 1, James A. Berkley 4,5,6, Bethou Adhisivam 3, Ramesh Agarwal 7, Nawshad Uddin Ahmed 8, Manica Balasegaram [...]

Published
2023
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8. Identification of potential novel combination antibiotic regimens based on drug-susceptibility and genetic diversity of Gram-negative bacteria causing neonatal sepsis in low- and middle-income countries

Author

Kakaraskoska Boceska, Biljana, primary, Vilken, Tuba, additional, Xavier, Basil Britto, additional, Lammens, Christine, additional, Ellis, Sally, additional, O`Brien, Seamus, additional, da Costa, Renata Maria Augusto, additional, Cook, Aislinn, additional, Russell, Neal J, additional, Bielicki, Julia, additional, Berezin, Eitan Naaman, additional, Roilides, Emmanual, additional, De Luca, Maia, additional, Romani, Lorenza, additional, Ballot, Daynia, additional, Dramowski, Angela, additional, Wadula, Jeannette, additional, Lochindarat, Sorasak, additional, Boonkasidecha, Suppawat, additional, Namiiro, Flavia, additional, Thi Bich Ngoc, Hoang, additional, Minh Dien, Tran, additional, Cressey, Tim R., additional, Preedisripipat, Kanchana, additional, Berkley, James A, additional, Musyimi, Robert, additional, Zarras, Charalampos, additional, Nana, Trusha, additional, Whitelaw, Andrew, additional, da Silva, Cely Barreto, additional, Jaglal, Prenika, additional, Ssengooba, Willy, additional, Saha, Samir K., additional, Islam, Mohammad Shahidul, additional, Mussi-Pinhata, Marisa Marcia, additional, Carvalheiro, Cristina Gardony, additional, Piddock, Laura, additional, Malhotra-Kumar, Surbhi, additional, Sharland, Mike, additional, Glupczynski, Youri, additional, and Goossens, Herman, additional

Published
2023
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9. A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance

Author

Chigome, Audrey, primary, Ramdas, Nishana, additional, Skosana, Phumzile, additional, Cook, Aislinn, additional, Schellack, Natalie, additional, Campbell, Stephen, additional, Lorenzetti, Giulia, additional, Saleem, Zikria, additional, Godman, Brian, additional, and Meyer, Johanna C., additional

Published
2023
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10. Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

Author

Sono, Tiyani Milta, primary, Yeika, Eugene, additional, Cook, Aislinn, additional, Kalungia, Aubrey, additional, Opanga, Sylvia A., additional, Acolatse, Joseph Elikem Efui, additional, Sefah, Israel Abebrese, additional, Jelić, Ana Golić, additional, Campbell, Stephen, additional, Lorenzetti, Giulia, additional, Ul Mustafa, Zia, additional, Marković-Peković, Vanda, additional, Kurdi, Amanj, additional, Anand Paramadhas, Bene D, additional, Rwegerera, Godfrey Mutashambara, additional, Amu, Adefolarin A, additional, Alabi, Mobolaji Eniola, additional, Wesangula, Evelyn, additional, Oluka, Margaret, additional, Khuluza, Felix, additional, Chikowe, Ibrahim, additional, Fadare, Joseph O., additional, Ogunleye, Olayinka O., additional, Kibuule, Dan, additional, Hango, Ester, additional, Schellack, Natalie, additional, Ramdas, Nishana, additional, Massele, Amos, additional, Mudenda, Steward, additional, Hoxha, Iris, additional, Moore, Catrin E., additional, Godman, Brian, additional, and Meyer, Johanna C., additional

Published
2023
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11. Association of Empiric Antibiotic Regimen Discordance With 30-Day Mortality in Neonatal and Pediatric Bloodstream Infection—A Global Retrospective Cohort Study

Author

Cook, Aislinn, Hsia, Yingfen, Russell, Neal, Sharland, Mike, Cheung, Kaman, Grimwood, Keith, Cross, Jack, Cotrim da Cunha, Denise, Magalhães, Gloria Regina, Renk, Hanna, Hindocha, Avni, McMaster, Paddy, Okomo, Uduak, Darboe, Saffiatou, Alvarez-Uria, Gerardo, Jinka, Dasaratha R., Murki, Srinivas, Kandraju, Hemasree, Dharmapalan, Dhanya, Esposito, Susanna, Bianchini, Sonia, Fukuoka, Kahoru, Aizawa, Yuta, Jimenez-Juarez, Rodolfo Norberto, Ojeda-Diezbarroso, Karla, Pirš, Mateja, Rožič, Mojca, Anugulruengkitt, Suvaporn, Jantarabenjakul, Watsamon, Cheng, Ching-Lan, Jian, Bai-Xiu, Spyridakis, Evangelos, Zaoutis, Theoklis, and Bielicki, Julia

Published
2021
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12. Challenges in the Implementation of the NeoOBS Study, a Global Pragmatic Observational Cohort Study, to Investigate the Aetiology and Management of Neonatal Sepsis in the Hospital Setting

Author

Riddell, Amy, primary, Cook, Aislinn, additional, Khavessian, Nathalie, additional, Ellis, Sally, additional, Bilardi, Davide, additional, Correia, Erika, additional, Kostyanev, Tomislav, additional, Nardone, Alessandra, additional, Russell, Neal, additional, Vilken, Tuba, additional, Stohr, Wolfgang, additional, Adhisivam, Bethou, additional, Moraes, Iana Rosa Alves de, additional, Ahmed, Nawshad Uddin, additional, Bekker, Adrie, additional, Berezin, Eitan Naaman, additional, Boonkasidecha, Suppawat, additional, Carvalheiro, Cristina G., additional, Chauhan, Prachi, additional, Chiurchiù, Sara, additional, Chorafa, Elisavet, additional, Dramowski, Angela, additional, DS, Madhusudhan, additional, Feng, Jinxing, additional, Jia, Shengnan, additional, Kong, Yuan, additional, Kyohere, Mary, additional, Kontou, Angeliki, additional, Lochindarat, Sorasak, additional, De Luca, Maia, additional, Mphaphuli, Aripfani, additional, Mussi-Pinhata, Marisa M., additional, Murunga, Sheila, additional, Nakwa, Firdose Lambey, additional, Nangia, Sushma, additional, Nassolo, Erinah, additional, Hoang, Ngoc Thi Bin, additional, Obiero, Christina W., additional, Olson, Linus, additional, Ping, Wang, additional, Plakkal, Nishad, additional, Prasad, Priyanka, additional, Preedisripipat, Kanchana, additional, Rahman, Sheikh Wasik, additional, Seef, Tiffany, additional, Sukrakanchana, Pra-ornsuda, additional, Thomas, Reenu, additional, Yu, Zhang, additional, Zhang, Qiaoru, additional, Walker, A. Sarah, additional, Bielicki, Julia, additional, Heath, Paul T., additional, Sharland, Michael, additional, and Munera-Huertas, Tatiana, additional

Published
2023
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13. A Narrative Review of Recent Antibiotic Prescribing Practices in Ambulatory Care in Tanzania: Findings and Implications.

Author

Massele, Amos, Rogers, Anastasia Martin, Gabriel, Deogratias, Mayanda, Ashura, Magoma, Sarah, Cook, Aislinn, Chigome, Audrey, Lorenzetti, Giulia, Meyer, Johanna C., Moore, Catrin E., Godman, Brian, and Minzi, Omary

Subjects
DRUG prescribing, OUTPATIENT medical care, MEDICAL personnel, INAPPROPRIATE prescribing (Medicine), ANTIMICROBIAL stewardship, NURSE prescribing
Abstract

Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care in Tanzania, including both the public and private sectors. These concerns need to be addressed as part of the national action plan (NAP) of Tanzania to reduce rising antimicrobial resistance (AMR) rates. Issues and concerns include high rates of prescribing of antibiotics for essentially self-limiting conditions. Consequently, there is a need to address this. As a result, the aims of this narrative review were to comprehensively summarize antibiotic utilization patterns particularly in ambulatory care and their rationale in Tanzania and to suggest ways forward to improve future prescribing practices. Materials and Methods: We undertook a narrative review of recently published studies and subsequently documented potential activities to improve future prescribing practices. Potential activities included instigating quality indicators and antimicrobial stewardship programs (ASPs). Results: Published studies have shown that antibiotics are being excessively prescribed in ambulatory care in Tanzania, in up to 95% to 96.3% of presenting cases depending on the sector. This is despite concerns with their appropriateness. High rates of antibiotic prescribing are not helped by variable adherence to current treatment guidelines. There have also been concerns with extensive prescribing of 'Watch' antibiotics in the private sector. Overall, the majority of antibiotics prescribed across the sectors, albeit inappropriately, were typically from the 'Access' group of antibiotics in the AWaRe (Access/Watch/Reserve) classification rather than 'Watch' antibiotics to limit AMR. The inappropriate prescribing of antibiotics in ambulatory care is linked to current knowledge regarding antibiotics, AMR, and ASPs among both prescribers and patients. Recommended activities for the future include improved education for all groups, the instigation of updated quality indicators, and the regular monitoring of prescribing practices against agreed-upon guidelines and indicators. Education for healthcare professionals on ASPs should start at undergraduate level and continue post qualification. Community advocacy on the rational use of antibiotics should also include social media activities to dispel misinformation. Conclusion: The quality of current prescribing practices of antibiotics in ambulatory care is sub-optimal in Tanzania. This needs to be urgently addressed. [ABSTRACT FROM AUTHOR]

Published
2023
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14. Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications

Author

Haseeb, Abdul, primary, Saleem, Zikria, additional, Maqadmi, Aseel Fayk, additional, Allehyani, Roaa Abdulrahman, additional, Mahrous, Ahmad J., additional, Elrggal, Mahmoud E., additional, Kamran, Sairah Hafeez, additional, AlGethamy, Manal, additional, Naji, Asem Saleh, additional, AlQarni, Abdullmoin, additional, Alhariqi, Khalid W., additional, Khan, Muhammad Arslan, additional, Ibrahim, Kiran, additional, Raees, Fahad, additional, Azmat, Aisha, additional, Cook, Aislinn, additional, Campbell, Stephen M., additional, Lorenzetti, Giulia, additional, Meyer, Johanna C., additional, Godman, Brian, additional, and Moore, Catrin E., additional

Published
2023
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15. Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study

Author

Cook, Aislinn, primary, Ferreras-Antolin, Laura, additional, Adhisivam, Bethou, additional, Ballot, Daynia, additional, Berkley, James A, additional, Bernaschi, Paola, additional, Carvalheiro, Cristina G, additional, Chaikittisuk, Napaporn, additional, Chen, Yunsheng, additional, Chibabhai, Vindana, additional, Chitkara, Shweta, additional, Chiurchiu, Sara, additional, Chorafa, Elisavet, additional, Dien, Tran Minh, additional, Dramowski, Angela, additional, de Matos, Samantha Faria, additional, Feng, Jinxing, additional, Jarovsky, Daniel, additional, Kaur, Ravinder, additional, Khamjakkaew, Warunee, additional, Laoyookhong, Premsak, additional, Machanja, Edwin, additional, Mussi-Pinhata, Marisa M, additional, Namiiro, Flavia, additional, Natraj, Gita, additional, Naziat, Hakka, additional, Ngoc, Hoang Thi Bich, additional, Ondongo-Ezhet, Claude, additional, Preedisripipat, Kanchana, additional, Rahman, Hafizur, additional, Riddell, Amy, additional, Roilides, Emmanuel, additional, Russell, Neal, additional, Sastry, Apurba S, additional, Tasimwa, Hannington Baluku, additional, Tongzhen, Ji, additional, Wadula, Jeannette, additional, Wang, Yajuan, additional, Whitelaw, Andrew, additional, Wu, Dan, additional, Yadav, Varsha, additional, Yang, Gao, additional, Stohr, Wolfgang, additional, Bielicki, Julia Anna, additional, Ellis, Sally, additional, Warris, Adilia, additional, Heath, Paul T, additional, and Sharland, Michael, additional

Published
2023
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16. Estimating antibiotic coverage from linked microbiological and clinical data from the Swiss Paediatric Sepsis Study to support empiric antibiotic regimen selection

Author

Cook, Aislinn, Atkinson, Andrew; https://orcid.org/0000-0001-5834-8315, Kronenberg, Andreas; https://orcid.org/0000-0002-0006-7833, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Swiss Pediatric Sepsis Study Group, Berger, Christoph; https://orcid.org/0000-0002-1730-8824, Bielicki, Julia Anna, Cook, Aislinn, Atkinson, Andrew; https://orcid.org/0000-0001-5834-8315, Kronenberg, Andreas; https://orcid.org/0000-0002-0006-7833, Agyeman, Philipp K A; https://orcid.org/0000-0002-8339-5444, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Swiss Pediatric Sepsis Study Group, Berger, Christoph; https://orcid.org/0000-0002-1730-8824, and Bielicki, Julia Anna

Abstract

In light of rising antibiotic resistance, better methods for selection of empiric antibiotic treatment based on clinical and microbiological data are needed. Most guidelines target specific clinical infections, and variably adjust empiric antibiotic selection by certain patient characteristics. Coverage estimates reflect the probability that an antibiotic regimen will be active against the causative pathogen once confirmed and can provide an objective basis for empiric regimen selection. Coverage can be estimated for specific infections using a weighted incidence syndromic combination antibiograms (WISCAs) framework. However, no comprehensive data combining clinical and microbiological data for specific clinical syndromes are available in Switzerland. We therefore describe estimating coverage from semi-deterministically linked routine microbiological and cohort data of hospitalised children with sepsis. Coverage estimates were generated for each hospital and separately pooling data across ten contributing hospitals for five pre-defined patient risk groups. Data from 1,082 patients collected during the Swiss Paediatric Sepsis Study (SPSS) 2011-2015 were included. Preterm neonates were the most commonly represented group, and half of infants and children had a comorbidity. 67% of neonatal sepsis cases were hospital-acquired late-onset whereas in children 76% of infections were community-acquired. Escherichia coli, Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common pathogens. At all hospitals, ceftazidime plus amikacin regimen had the lowest coverage, and coverage of amoxicillin plus gentamicin and meropenem were generally comparable. Coverage was improved when vancomycin was included in the regimen, reflecting uncertainty about the empirically targeted pathogen spectrum. Children with community-acquired infections had high coverage overall. It is feasible to estimate coverage of common empiric antibiotic regimens from linked data. P

Published
2023

17. Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future

Author

Saleem, Zikria, primary, Godman, Brian, additional, Cook, Aislinn, additional, Khan, Muhammad Arslan, additional, Campbell, Stephen M., additional, Seaton, Ronald Andrew, additional, Siachalinga, Linda, additional, Haseeb, Abdul, additional, Amir, Afreenish, additional, Kurdi, Amanj, additional, Mwita, Julius C., additional, Sefah, Israel Abebrese, additional, Opanga, Sylvia A., additional, Fadare, Joseph O., additional, Ogunleye, Olayinka O., additional, Meyer, Johanna C., additional, Massele, Amos, additional, Kibuule, Dan, additional, Kalungia, Aubrey C., additional, Shahwan, Moyad, additional, Nabayiga, Hellen, additional, Pichierri, Giuseppe, additional, and Moore, Catrin E., additional

Published
2022
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18. Implementation of infection prevention and control for hospitalized neonates: A narrative review

Author

Nyantakyi, Emanuela, primary, Caci, Laura, additional, Castro, Marta, additional, Schlaeppi, Chloé, additional, Cook, Aislinn, additional, Albers, Bianca, additional, Walder, Joel, additional, Metsvaht, Tuuli, additional, Bielicki, Julia, additional, Dramowski, Angela, additional, Schultes, Marie-Therese, additional, and Clack, Lauren, additional

Published
2022
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19. The NeoSep Severity and Recovery scores to predict mortality in hospitalized neonates and young infants with sepsis derived from the global NeoOBS observational cohort study

Author

Russell, Neal, primary, Stöhr, Wolfgang, additional, Cook, Aislinn, additional, Berkley, James A, additional, Adhisivam, Bethou, additional, Agarwal, Ramesh, additional, Ahmed, Nawshad Uddin, additional, Balasegaram, Manica, additional, Chami, Neema, additional, Bekker, Adrie, additional, Bilardi, Davide, additional, Carvalheiro, Cristina G., additional, Chaurasia, Suman, additional, Favarin Colas, Viviane Rinaldi, additional, Cousens, Simon, additional, Dantas de Assis, Ana Carolina, additional, Dong, Han, additional, Dramowski, Angela, additional, Dung, Nguyen Trong, additional, Feng, Jinxing, additional, Glupczynski, Youri, additional, Goel, Srishti, additional, Goossens, Herman, additional, Huong Hao, Doan Thi, additional, Hasan, Mahmudul, additional, Huertas, Tatiana Munera, additional, Khavessian, Nathalie, additional, Kontou, Angeliki, additional, Kostyanev, Tomislav, additional, Laoyookhon, Premsak, additional, Lochindarat, Sorasak, additional, De Luca, Maia, additional, Malhotra-Kumar, Surbhi, additional, Mondal, Nivedita, additional, Mundhra, Nitu, additional, Musoke, Philippa, additional, Mussi-Pinhata, Marisa M., additional, Nanavati, Ruchi, additional, Nakwa, Firdose L., additional, Nangia, Sushma, additional, Nardone, Alessandra, additional, Nyaoke, Borna, additional, Obiero, Christina W, additional, Ping, Wang, additional, Preedisripipat, Kanchana, additional, Qazi, Shamim, additional, Qi, Lifeng, additional, Riddell, Amy, additional, Romani, Lorenza, additional, Roysuwan, Praewpan, additional, Saggers, Robin, additional, Saha, Samir, additional, Sarafidis, Kosmas, additional, Tusibira, Valerie, additional, Velaphi, Sithembiso, additional, Vilken, Tuba, additional, Wang, Xiaojiao, additional, Wang, Yajuan, additional, Yang, Yonghong, additional, Ellis, Sally, additional, Bielicki, Julia, additional, Walker, A Sarah, additional, Heath, Paul T., additional, and Sharland, Mike, additional

Published
2022
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20. Patterns of antibiotic use, pathogens and clinical outcomes in hospitalised neonates and young infants with sepsis in the NeoOBS global neonatal sepsis observational cohort study

Author

Russell, Neal, primary, Stöhr, Wolfgang, additional, Plakkal, Nishad, additional, Cook, Aislinn, additional, Berkley, James A, additional, Adhisivam, Bethou, additional, Agarwal, Ramesh, additional, Balasegaram, Manica, additional, Ballot, Daynia, additional, Bekker, Adrie, additional, Berezin, Eitan Naaman, additional, Bilardi, Davide, additional, Boonkasidecha, Suppawat, additional, Carvalheiro, Cristina G., additional, Chaurasia, Suman, additional, Chiurchiu, Sara, additional, Cousens, Simon, additional, Cressey, Tim R., additional, Dien, Tran Minh, additional, Ding, Yijun, additional, Dramowski, Angela, additional, DS, Madhusudhan, additional, Dudeja, Ajay, additional, Feng, Jinxing, additional, Glupczynski, Youri, additional, Goossens, Herman, additional, Huertas, Tatiana Munera, additional, Islam, Mohammad Shahidul, additional, Jarovsky, Daniel, additional, Khavessian, Nathalie, additional, Khorana, Meera, additional, Kostyanev, Tomislav, additional, Larsson, Mattias, additional, Luca, Maia De, additional, Malhotra-Kumar, Surbhi, additional, Mussi-Pinhata, Marisa M., additional, Nanavati, Ruchi, additional, Nangia, Sushma, additional, Nankunda, Jolly, additional, Nardone, Alessandra, additional, Nyaoke, Borna, additional, Obiero, Christina W, additional, Owor, Maxensia, additional, Ping, Wang, additional, Preedisripipat, Kanchana, additional, Qazi, Shamim, additional, Ramdin, Tanusha, additional, Riddell, Amy, additional, Roilides, Emmanuel, additional, Saha, Samir K, additional, Sarafidis, Kosmas, additional, Thomas, Reenu, additional, Velaphi, Sithembiso, additional, Vilken, Tuba, additional, Wang, Yajuan, additional, Yang, Yonghong, additional, Zunjie, Liu, additional, Ellis, Sally, additional, Bielicki, Julia, additional, Walker, A Sarah, additional, Heath, Paul T., additional, and Sharland, Mike, additional

Published
2022
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23. Clinical Presentation and 28-Day Mortality in Hospitalized Neonates and Young Infants with Clinical Sepsis: The Global NeoOBS Observational Cohort

Author

Russell, Neal, primary, Stöhr, Wolfgang, additional, Plakkal, Nishad, additional, Cook, Aislinn, additional, Berkley, James A., additional, Adhisivam, Bethou, additional, Agarwal, Ramesh, additional, Balasegaram, Manica, additional, Ballot, Daynia, additional, Bekker, Adrie, additional, Berezin, Eitan Naaman, additional, Bilardi, Davide, additional, Boonkasidecha, Suppawat, additional, Carvalheiro, Cristina G., additional, Chaurasia, Suman, additional, Chiurchiu, Sara, additional, Cousens, Simon, additional, Cressey, Tim R., additional, Dien, Trah Minh, additional, Ding, Yijun, additional, Dramowski, Angela, additional, DS, Madhusudhan, additional, Dudeja, Ajay, additional, Feng, Jinxing, additional, Glupczynski, Youri, additional, Goossens, Herman, additional, Islam, Mohammad Shahidul, additional, Jarovsky, Daniel, additional, Khavessian, Nathalie, additional, Khorona, Meera, additional, Kostyanev, Tomislav, additional, Larsson, Matthias, additional, Luca, Maia De, additional, Malhotra-Kumar, Surbhi, additional, Mussi-Pinhata, Marisa M., additional, Nanavati, Ruchi, additional, Nangia, Sushma, additional, Nankunda, Jolly, additional, Nyaoke, Borna, additional, Obiero, Christina W., additional, Owor, Maxensia, additional, Ping, Wang, additional, Preedisripipat, Kanchana, additional, Qazi, Shamim, additional, Ramdin, Tanusha, additional, Riddell, Amy, additional, Roilides, Emmanuel, additional, Saha, Samir, additional, Sarafidis, Kosmas, additional, Thomas, Reenu, additional, Velaphi, Sithembiso Christopher, additional, Vilken, Tuba, additional, Wang, Yajuan, additional, Yang, Yonghong, additional, Zunjie, Liu, additional, Ellis, Sally, additional, Bielicki, Julia, additional, Walker, Sarah, additional, Heath, Paul T., additional, and Sharland, Mike, additional

Published
2021
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24. Analysis from the NeoOBS Global Neonatal Sepsis Prospective Observational Cohort Study Across 19 Hospitals in 11 Countries; Clinical Presentation, Treatment, Mortality Outcomes and Development of the NeoSEP Sepsis Severity Score

Author

Russell, Neal, primary, Stöhr, Wolfgang, additional, Plakkal, Nishad, additional, Cook, Aislinn, additional, Berkley, James A., additional, Adhisivam, Bethou, additional, Agarwal, Ramesh, additional, Balasegaram, Manica, additional, Ballot, Daynia, additional, Bekker, Adrie, additional, Berezin, Eitan Naaman, additional, Bilardi, Davide, additional, Boonkasidecha, Suppawat, additional, Carvalheiro, Cristina G., additional, Chaurasia, Suman, additional, Chiurchiu, Sara, additional, Cousens, Simon, additional, Cressey, Tim R., additional, Dien, Trah Minh, additional, Ding, Yijun, additional, Dramowski, Angela, additional, Ds, Madhusudhan, additional, Dudeja, Ajay, additional, Feng, Jinxing, additional, Glupczynski, Youri, additional, Goossens, Herman, additional, Islam, Mohammad Shahidul, additional, Jarovsky, Daniel, additional, Khavessian, Nathalie, additional, Khorona, Meera, additional, Kostyanev, Tomislav, additional, Larsson, Matthias, additional, Luca, Maia De, additional, Malhotra-Kumar, Surbhi, additional, Mussi-Pinhata, Marisa M., additional, Nanavati, Ruchi, additional, Nangia, Sushma, additional, Nankunda, Jolly, additional, Nyaoke, Borna, additional, Obiero, Christina W., additional, Owor, Maxensia, additional, Ping, Wang, additional, Preedisripipat, Kanchana, additional, Qazi, Shamim, additional, Ramdin, Tanusha, additional, Riddell, Amy, additional, Roilides, Emmanuel, additional, Saha, Samir, additional, Sarafidis, Kosmas, additional, Thomas, Reenu, additional, Velaphi, Sithembiso Christopher, additional, Vilken, Tuba, additional, Wang, Yajuan, additional, Yang, Yonghong, additional, Zunjie, Liu, additional, Ellis, Sally, additional, Bielicki, Julia, additional, Walker, Sarah, additional, Heath, Paul T., additional, and Sharland, Mike, additional

Published
2021
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25. Improving empiric antibiotic prescribing in pediatric bloodstream infections: a potential application of weighted-incidence syndromic combination antibiograms (WISCA).

Author

Cook, Aislinn, Sharland, Mike, Yau, Yasmine, Group*, PediBSI, and Bielicki, Julia

Abstract

Increasing antibiotic resistance to WHO-recommended first- and second-line treatments of pediatric sepsis requires adaptation of prescribing guidelines. We discuss the potential and limitations of a weighted-incidence syndromic combination antibiogram (WISCA) as a practical tool for incorporating local microbiology data when assessing empiric coverage of commonly used antibiotics. A brief questionnaire of 18 clinically significant isolates from pediatric blood cultures (Jan-Dec 2018) was sent to a global network of pediatric hospitals in July 2019. Weighted coverage estimates of non-antipseudomonal third-generation cephalosporins (3GC) and meropenem were estimated using Monte–Carlo simulation for each site reporting >100 isolates. 52 hospitals in 23 countries in 5 WHO regions responded to the questionnaire; 13 sites met the sample size requirement. The most common isolates were S. aureus, Klebsiella spp., E. coli and Enterococcus spp. Coverage of 3GC ranged from 39% [95%CrI: 34–43%] to 73% (two sites: [95%CrI: 65–80%]; [95%CrI: 68–86%]) and meropenem coverage ranged from 54% [95%CrI: 47–60%] to 88% [95%CrI:84–91%]. A WISCA is a data-driven, clinically intuitive tool that can be used to compare empiric antibiotic regimens for pediatric sepsis using existing large datasets. The estimates can be further refined using more complex meta-analytical methods and patient characteristics. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial

Author

Folegatti, Pedro M, primary, Ewer, Katie J, additional, Aley, Parvinder K, additional, Angus, Brian, additional, Becker, Stephan, additional, Belij-Rammerstorfer, Sandra, additional, Bellamy, Duncan, additional, Bibi, Sagida, additional, Bittaye, Mustapha, additional, Clutterbuck, Elizabeth A, additional, Dold, Christina, additional, Faust, Saul N, additional, Finn, Adam, additional, Flaxman, Amy L, additional, Hallis, Bassam, additional, Heath, Paul, additional, Jenkin, Daniel, additional, Lazarus, Rajeka, additional, Makinson, Rebecca, additional, Minassian, Angela M, additional, Pollock, Katrina M, additional, Ramasamy, Maheshi, additional, Robinson, Hannah, additional, Snape, Matthew, additional, Tarrant, Richard, additional, Voysey, Merryn, additional, Green, Catherine, additional, Douglas, Alexander D, additional, Hill, Adrian V S, additional, Lambe, Teresa, additional, Gilbert, Sarah C, additional, Pollard, Andrew J, additional, Aboagye, Jeremy, additional, Adams, Kelly, additional, Ali, Aabidah, additional, Allen, Elizabeth, additional, Allison, Jennifer L., additional, Anslow, Rachel, additional, Arbe-Barnes, Edward H., additional, Babbage, Gavin, additional, Baillie, Kenneth, additional, Baker, Megan, additional, Baker, Natalie, additional, Baker, Philip, additional, Baleanu, Ioana, additional, Ballaminut, Juliana, additional, Barnes, Eleanor, additional, Barrett, Jordan, additional, Bates, Louise, additional, Batten, Alexander, additional, Beadon, Kirsten, additional, Beckley, Rebecca, additional, Berrie, Eleanor, additional, Berry, Lisa, additional, Beveridge, Amy, additional, Bewley, Kevin R., additional, Bijker, Else Margreet, additional, Bingham, Tracey, additional, Blackwell, Luke, additional, Blundell, Caitlin L., additional, Bolam, Emma, additional, Boland, Elena, additional, Borthwick, Nicola, additional, Bower, Thomas, additional, Boyd, Amy, additional, Brenner, Tanja, additional, Bright, Philip D., additional, Brown-O'Sullivan, Charlie, additional, Brunt, Emily, additional, Burbage, Jamie, additional, Burge, Sharon, additional, Buttigieg, Karen R., additional, Byard, Nicholas, additional, Cabera Puig, Ingrid, additional, Calvert, Anna, additional, Camara, Susana, additional, Cao, Michelangelo, additional, Cappuccini, Federica, additional, Carr, Melanie, additional, Carroll, Miles W., additional, Carter, Victoria, additional, Cathie, Katrina, additional, Challis, Ruth J., additional, Charlton, Sue, additional, Chelysheva, Irina, additional, Cho, Jee-Sun, additional, Cicconi, Paola, additional, Cifuentes, Liliana, additional, Clark, Helen, additional, Clark, Elizabeth, additional, Cole, Tom, additional, Colin-Jones, Rachel, additional, Conlon, Christopher P., additional, Cook, Aislinn, additional, Coombes, Naomi S., additional, Cooper, Rachel, additional, Cosgrove, Catherine A., additional, Coy, Karen, additional, Crocker, Wendy E.M., additional, Cunningham, Christina J., additional, Damratoski, Brad E., additional, Dando, Lynne, additional, Datoo, Mehreen S., additional, Davies, Hannah, additional, De Graaf, Hans, additional, Demissie, Tesfaye, additional, Di Maso, Claudio, additional, Dietrich, Isabelle, additional, Dong, Tao, additional, Donnellan, Francesca R., additional, Douglas, Naomi, additional, Downing, Charlotte, additional, Drake, Jonathan, additional, Drake-Brockman, Rachael, additional, Drury, Ruth Elizabeth, additional, Dunachie, Susanna Jane, additional, Edwards, Nick J., additional, Edwards, Frances D.L., additional, Edwards, Chris J., additional, Elias, Sean C., additional, Elmore, Michael J., additional, Emary, Katherine R.W., additional, English, Marcus Rex, additional, Fagerbrink, Susanne, additional, Felle, Sally, additional, Feng, Shuo, additional, Field, Samantha, additional, Fixmer, Carine, additional, Fletcher, Clare, additional, Ford, Karen J., additional, Fowler, Jamie, additional, Fox, Polly, additional, Francis, Emma, additional, Frater, John, additional, Furze, Julie, additional, Fuskova, Michelle, additional, Galiza, Eva, additional, Gbesemete, Diane, additional, Gilbride, Ciaran, additional, Godwin, Kerry, additional, Gorini, Giacomo, additional, Goulston, Lyndsey, additional, Grabau, Caroline, additional, Gracie, Lara, additional, Gray, Zoe, additional, Guthrie, Lucy Belle, additional, Hackett, Mark, additional, Halwe, Sandro, additional, Hamilton, Elizabeth, additional, Hamlyn, Joseph, additional, Hanumunthadu, Brama, additional, Harding, Irasha, additional, Harris, Stephanie A., additional, Harris, Andrew, additional, Harrison, Daisy, additional, Harrison, Clare, additional, Hart, Thomas C., additional, Haskell, Louise, additional, Hawkins, Sophia, additional, Head, Ian, additional, Henry, John Aaron, additional, Hill, Jennifer, additional, Hodgson, Susanne H.C., additional, Hou, Mimi M., additional, Howe, Elizabeth, additional, Howell, Nicola, additional, Hutlin, Cecilia, additional, Ikram, Sabina, additional, Isitt, Catherine, additional, Iveson, Poppy, additional, Jackson, Susan, additional, Jackson, Frederic, additional, James, Sir William, additional, Jenkins, Megan, additional, Jones, Elizabeth, additional, Jones, Kathryn, additional, Jones, Christine E., additional, Jones, Bryony, additional, Kailath, Reshma, additional, Karampatsas, Konstantinos, additional, Keen, Jade, additional, Kelly, Sarah, additional, Kelly, Dearbhla, additional, Kerr, David, additional, Kerridge, Simon, additional, Khan, Liaquat, additional, Khan, Uzma, additional, Killen, Annabel, additional, Kinch, Jasmin, additional, King, Thomas B., additional, King, Lloyd, additional, King, Jade, additional, Kingham-Page, Lucy, additional, Klenerman, Paul, additional, Knapper, Francesca, additional, Knight, Julian C., additional, Knott, Daniel, additional, Koleva, Stanislava, additional, Kupke, Alexandra, additional, Larkworthy, Colin W., additional, Larwood, Jessica P.J., additional, Laskey, Anna, additional, Lawrie, Alison M., additional, Lee, Arlene, additional, Ngan Lee, Kim Yee, additional, Lees, Emily A, additional, Legge, Helen, additional, Lelliott, Alice, additional, Lemm, Nana-Marie, additional, Lias, Amelia M., additional, Linder, Aline, additional, Lipworth, Samuel, additional, Liu, Xinxue, additional, Liu, Shuchang, additional, Lopez Ramon, Raquel, additional, Lwin, May, additional, Mabesa, Francesca, additional, Madhavan, Meera, additional, Mallett, Garry, additional, Mansatta, Kushal, additional, Marcal, Ines, additional, Marinou, Spyridoula, additional, Marlow, Emma, additional, Marshall, Julia L., additional, Martin, Jane, additional, McEwan, Joanne, additional, McInroy, Lorna, additional, Meddaugh, Gretchen, additional, Mentzer, Alexander J., additional, Mirtorabi, Neginsadat, additional, Moore, Maria, additional, Moran, Edward, additional, Morey, Ella, additional, Morgan, Victoria, additional, Morris, Susan Jane, additional, Morrison, Hazel, additional, Morshead, Gertraud, additional, Morter, Richard, additional, Mujadidi, Yama F., additional, Muller, Jilly, additional, Munera-Huertas, Tatiana, additional, Munro, Claire, additional, Munro, Alasdair, additional, Murphy, Sarah, additional, Munster, Vincent J., additional, Mweu, Philomena, additional, Noé, Andrés, additional, Nugent, Fay L., additional, Nuthall, Elizabeth, additional, O'Brien, Katie, additional, O'Connor, Daniel, additional, Oguti, Blanché, additional, Oliver, Jennifer L., additional, Oliveira, Catarina, additional, O'Reilly, Peter John, additional, Osborn, Mairead, additional, Osborne, Piper, additional, Owen, Cathy, additional, Owens, Daniel, additional, Owino, Nelly, additional, Pacurar, Mihaela, additional, Parker, Kaye, additional, Parracho, Helena, additional, Patrick-Smith, Maia, additional, Payne, Victoria, additional, Pearce, Jennifer, additional, Peng, Yanchun, additional, Peralta Alvarez, Marco Polo, additional, Perring, James, additional, Pfafferott, Katja, additional, Pipini, Dimitra, additional, Plested, Emma, additional, Pluess-Hall, Helen, additional, Pollock, Katrina, additional, Poulton, Ian, additional, Presland, Laura, additional, Provstgaard-Morys, Samuel, additional, Pulido, David, additional, Radia, Kajal, additional, Ramos Lopez, Fernando, additional, Rand, Jade, additional, Ratcliffe, Helen, additional, Rawlinson, Thomas, additional, Rhead, Sarah, additional, Riddell, Amy, additional, Ritchie, Adam John, additional, Roberts, Hannah, additional, Robson, Joanna, additional, Roche, Sophie, additional, Rohde, Cornelius, additional, Rollier, Christine S., additional, Romani, Rossana, additional, Rudiansyah, Indra, additional, Saich, Stephen, additional, Sajjad, Sara, additional, Salvador, Stephannie, additional, Sanchez Riera, Lidia, additional, Sanders, Helen, additional, Sanders, Katherine, additional, Sapaun, Shari, additional, Sayce, Chloe, additional, Schofield, Ella, additional, Screaton, Gavin, additional, Selby, Beatrice, additional, Semple, Calum, additional, Sharpe, Hannah R., additional, Shaik, Imam, additional, Shea, Adam, additional, Shelton, Holly, additional, Silk, Sarah, additional, Silva-Reyes, Laura, additional, Skelly, Donal T., additional, Smee, Heather, additional, Smith, Catherine C., additional, Smith, David J., additional, Song, Rinn, additional, Spencer, Alexandra J., additional, Stafford, Elizabeth, additional, Steele, Amy, additional, Stefanova, Elena, additional, Stockdale, Lisa, additional, Szigeti, Anna, additional, Tahiri-Alaoui, Abdessamad, additional, Tait, Moira, additional, Talbot, Helen, additional, Tanner, Rachel, additional, Taylor, Iona Jennifer, additional, Taylor, Victoria, additional, Te Water Naude, Rebecca, additional, Thakur, Nazia, additional, Themistocleous, Yrene, additional, Themistocleous, Andreas, additional, Thomas, Merin, additional, Thomas, Tonia M., additional, Thompson, Amber, additional, Thomson-Hill, Samantha, additional, Tomlins, Jennifer, additional, Tonks, Susan, additional, Towner, James, additional, Tran, Nguyen, additional, Tree, Julia A., additional, Truby, Adam, additional, Turkentine, Kate, additional, Turner, Cheryl, additional, Turner, Nicola, additional, Turner, Sally, additional, Tuthill, Toby, additional, Ulaszewska, Marta, additional, Varughese, Rachel, additional, Van Doremalen, Neeltje, additional, Veighey, Kristin, additional, Verheul, Marije K., additional, Vichos, Iason, additional, Vitale, Elia, additional, Walker, Laura, additional, Watson, Marion E.E., additional, Welham, Benjamin, additional, Wheat, Julie, additional, White, Caroline, additional, White, Rachel, additional, Worth, Andrew T., additional, Wright, Danny, additional, Wright, Suzie, additional, Yao, Xin Li, additional, and Yau, Yasmine, additional

Published
2020
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28. Significantly lower rates of antibiotic prescribing for hospital acquired infections in low income settings than high income settings in the GARPEC study

Author

Cook, Aislinn

Abstract

Significantly lower rates of antibiotic prescribing for hospital acquired infections in low income settings than high income settings in the GARPEC studyAuthors: Aislinn Cook1, Rebecca Lundin2, Yingfen Hsia1, Julia Bielicki1, Mike Sharland11 St. Georgeu2019s University of London, London, United Kingdom 2 PENTA Foundation, Padua, ItalyBackground:tThere is very limited data on neonatal and paediatric hospital-acquired infection (HAI) rates globally. Future interventional studies of infection prevention and control will require baseline data on hospital structures and prescribing for HAI. This study aims to describe the characteristics of centres participating in the Global Antimicrobial Resistance, Prescribing and Efficacy among Neonates and Children (GARPEC) project, and prescribing patterns for HAI. Methods: tGARPEC recruited a global convenience sample of 83 hospitals treating paediatric and neonatal infections. Hospital data including bed counts, presence of Neonatal Intensive Care Unit (NICU) and Paediatric Intensive Care Unit (PICU) wards and annual admissions were collected. Antibiotic (ATC code J01) prescription data were collected through four point prevalence surveys (PPS) between February 2016 and February 2017. Results:t63.9% (53/83) of centres provided both hospital data and prescribing data representing 5 WHO regions. Most facilities were paediatric and neonatal units within larger hospitals. PICU/NICU size and annual admissions were comparable between high income countries (HIC), upper middle income countries (UMIC) and low/middle income countries (LMIC). HIC and LMIC reported more NICU admissions per year than UMIC (Table 1). 33.7% (719/2134) of paediatric prescriptions in HIC (n=25) were for HAI versus 21.5% (685/3180) in UMIC (n=19) and only 1.7% (5/288) in LMIC (n=9). 41.1% (196/477) of neonatal treatment indications in HIC were for HAI compared to 18.9% (184/975) in UMIC and 34.9% (73/209) in LMIC. Conclusion: tIn these centres, HAI accounted for a higher percentage of prescriptions in HIC than UMIC and LMIC. Previous limited data has suggested that rates of HAI are higher in LMIC, suggesting possible under-diagnosis and treatment of HAI in LMIC or more frequent use of combination therapy in HIC in the GARPEC study. The difference between settings is particularly great for paediatric HAI prescriptions compared to neonatal HAI prescriptions. Given the sampling bias of the GARPEC facilities, future studies are needed to validate these findings in other settings, perhaps conducting combined HAI and antibiotic PPS.

Published
2017

31. Estimating antibiotic coverage from linked microbiological and clinical data from the Swiss Paediatric Sepsis Study to support empiric antibiotic regimen selection.

Author

Cook A, Atkinson A, Kronenberg A, Agyeman PKA, Schlapbach LJ, Berger C, and Bielicki JA

Abstract

In light of rising antibiotic resistance, better methods for selection of empiric antibiotic treatment based on clinical and microbiological data are needed. Most guidelines target specific clinical infections, and variably adjust empiric antibiotic selection by certain patient characteristics. Coverage estimates reflect the probability that an antibiotic regimen will be active against the causative pathogen once confirmed and can provide an objective basis for empiric regimen selection. Coverage can be estimated for specific infections using a weighted incidence syndromic combination antibiograms (WISCAs) framework. However, no comprehensive data combining clinical and microbiological data for specific clinical syndromes are available in Switzerland. We therefore describe estimating coverage from semi-deterministically linked routine microbiological and cohort data of hospitalised children with sepsis. Coverage estimates were generated for each hospital and separately pooling data across ten contributing hospitals for five pre-defined patient risk groups. Data from 1,082 patients collected during the Swiss Paediatric Sepsis Study (SPSS) 2011-2015 were included. Preterm neonates were the most commonly represented group, and half of infants and children had a comorbidity. 67% of neonatal sepsis cases were hospital-acquired late-onset whereas in children 76% of infections were community-acquired. Escherichia coli , Coagulase-negative staphylococci (CoNS) and Staphylococcus aureus were the most common pathogens. At all hospitals, ceftazidime plus amikacin regimen had the lowest coverage, and coverage of amoxicillin plus gentamicin and meropenem were generally comparable. Coverage was improved when vancomycin was included in the regimen, reflecting uncertainty about the empirically targeted pathogen spectrum. Children with community-acquired infections had high coverage overall. It is feasible to estimate coverage of common empiric antibiotic regimens from linked data. Pooling data by patient risk groups with similar expected pathogen and susceptibility profiles may improve coverage estimate precision, supporting better differentiation of coverage between regimens. Identification of data sources, selection of regimens and consideration of pathogens to target for improved empiric coverage is important., Competing Interests: UH declares consulting fees from Global Pertussis Initiative (since 2001, Sanofi-Pasteur USA); Central and Eastern Europe Pertussis Awareness Group (since 2011, Sanofi-Pasteur France) and lecture fees (product independent) from Infectopharm Germany. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Cook, Atkinson, Kronenberg, Agyeman, Schlapbach, Swiss Pediatric Sepsis Study Group, Berger and Bielicki.)

Published
2023
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