Epidemiology of infections and antimicrobial use in Greek Neonatal Units.

TitleEpidemiology of infections and antimicrobial use in Greek Neonatal Units.
Publication TypeJournal Article
Year of Publication2018
AuthorsGkentzi D, Kortsalioudaki C, Cailes BC, Zaoutis TE, Kopsidas J, Tsolia M, Spyridis N, Siahanidou S, Sarafidis K, Heath PT, Dimitriou G
Corporate AuthorsNeonatal Infection Surveillance Network in Greece
JournalArch Dis Child Fetal Neonatal Ed
Date Published2018 Jun 28
ISSN1468-2052
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%). (80%) were the most common Gram-positive organisms causing LOS and spp (39%) the most common Gram-negative. Nearly half (45%) of the 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.

DOI10.1136/archdischild-2018-315024
Alternate JournalArch. Dis. Child. Fetal Neonatal Ed.
PubMed ID29954881