Patterns of isolates in blood cultures and antibiotic resistance profiles over five years, in a tertiary surgical neonatal unit
Background Neonatal sepsis with bacteraemia causes high morbidity and mortality. Early empirical antibiotics are essential to reduce this. Antibiotic policies are based on local epidemiological data of pathogens and resistance profiles. Objective Identify bacteraemia pathogens and antibiotic resista...
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| Veröffentlicht in: | Archives of disease in childhood 2012-05, Vol.97 (Suppl 1), p.A34-A35 |
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| creator | Valappil, S Demertzi, E Grant, M Chuang, S Ogundipe, E |
| description | Background Neonatal sepsis with bacteraemia causes high morbidity and mortality. Early empirical antibiotics are essential to reduce this. Antibiotic policies are based on local epidemiological data of pathogens and resistance profiles. Objective Identify bacteraemia pathogens and antibiotic resistance rates including incidence of Extended Spectrum Beta Lactamase producing Enterobacteriacae, thus informing policy. Compare pathogen profile in Medical versus Surgical admissions. Methods Positive blood cultures from January 2006 to December 2010 were analysed. False positives were excluded using concurrent laboratory results (from date of positive culture to 10 days after) if CRP |
| doi_str_mv | 10.1136/archdischild-2012-301885.86 |
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Early empirical antibiotics are essential to reduce this. Antibiotic policies are based on local epidemiological data of pathogens and resistance profiles. Objective Identify bacteraemia pathogens and antibiotic resistance rates including incidence of Extended Spectrum Beta Lactamase producing Enterobacteriacae, thus informing policy. Compare pathogen profile in Medical versus Surgical admissions. Methods Positive blood cultures from January 2006 to December 2010 were analysed. False positives were excluded using concurrent laboratory results (from date of positive culture to 10 days after) if CRP<10, WCC<22 & Platelets>100, along with clinical data from electronic database (SEND) for secondary outcomes. Results The average positive blood cultures for all 5 years was 15.1%, of which Cogulase negative Staphylococci (clinically significant only) was 48.8%, Enterobacteriaceae was 21.8%, group B streptococcus 2.9% and the rest were S Aureus, Enterobacter and others. The Cefotoxime resistant Enterobacteriaceae were 18.9%. Tazocin resistance was 36.7%, and Gentamycin resistance (excluding Pseudomonas) was 2.1%. Commonest pathogens in early onset sepsis (<48 hours age) n=28 (6.6%), were GBS (35%) & coliforms (23%), and in late onset sepsis (n=392) CoNS (48%), Enterococcus (9.1%) and Klebsiella (6.8%). No candidaemia in 2009-10, despite surgical antibiotics. There was no significant differences in pathogens between surgical (n=232) and medical (n=188) infants. In 5 years, 11 babies died during episodes of sepsis and 2 term babies had cerebral bleed, reflecting the bane of sepsis. Conclusion Pathogens and resistance patterns were stable with a decreasing trend in Tazocin resistance. Tazocin with Gentamicin (resistance 2.1%) is a reasonable 2nd line for late onset sepsis. ESBL rate was 18.9% compared with BSPI National surveillance data (26%), probably attributable to low Cephalosporin use. Since pathogen profiles change, it is important to review epidemiology periodically.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2012-301885.86</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Antibiotic resistance ; Antibiotics ; Blood ; Enterobacter ; Enterobacteriacae ; Enterobacteriaceae ; Enterococcus ; Epidemiology ; Klebsiella ; Pathogens ; Pseudomonas ; Streptococcus</subject><ispartof>Archives of disease in childhood, 2012-05, Vol.97 (Suppl 1), p.A34-A35</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/97/Suppl_1/A34.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/97/Suppl_1/A34.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3195,23570,27923,27924,77471,77502</link.rule.ids></links><search><creatorcontrib>Valappil, S</creatorcontrib><creatorcontrib>Demertzi, E</creatorcontrib><creatorcontrib>Grant, M</creatorcontrib><creatorcontrib>Chuang, S</creatorcontrib><creatorcontrib>Ogundipe, E</creatorcontrib><title>Patterns of isolates in blood cultures and antibiotic resistance profiles over five years, in a tertiary surgical neonatal unit</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Background Neonatal sepsis with bacteraemia causes high morbidity and mortality. Early empirical antibiotics are essential to reduce this. Antibiotic policies are based on local epidemiological data of pathogens and resistance profiles. Objective Identify bacteraemia pathogens and antibiotic resistance rates including incidence of Extended Spectrum Beta Lactamase producing Enterobacteriacae, thus informing policy. Compare pathogen profile in Medical versus Surgical admissions. Methods Positive blood cultures from January 2006 to December 2010 were analysed. False positives were excluded using concurrent laboratory results (from date of positive culture to 10 days after) if CRP<10, WCC<22 & Platelets>100, along with clinical data from electronic database (SEND) for secondary outcomes. Results The average positive blood cultures for all 5 years was 15.1%, of which Cogulase negative Staphylococci (clinically significant only) was 48.8%, Enterobacteriaceae was 21.8%, group B streptococcus 2.9% and the rest were S Aureus, Enterobacter and others. The Cefotoxime resistant Enterobacteriaceae were 18.9%. Tazocin resistance was 36.7%, and Gentamycin resistance (excluding Pseudomonas) was 2.1%. Commonest pathogens in early onset sepsis (<48 hours age) n=28 (6.6%), were GBS (35%) & coliforms (23%), and in late onset sepsis (n=392) CoNS (48%), Enterococcus (9.1%) and Klebsiella (6.8%). No candidaemia in 2009-10, despite surgical antibiotics. There was no significant differences in pathogens between surgical (n=232) and medical (n=188) infants. In 5 years, 11 babies died during episodes of sepsis and 2 term babies had cerebral bleed, reflecting the bane of sepsis. Conclusion Pathogens and resistance patterns were stable with a decreasing trend in Tazocin resistance. Tazocin with Gentamicin (resistance 2.1%) is a reasonable 2nd line for late onset sepsis. ESBL rate was 18.9% compared with BSPI National surveillance data (26%), probably attributable to low Cephalosporin use. Since pathogen profiles change, it is important to review epidemiology periodically.</description><subject>Antibiotic resistance</subject><subject>Antibiotics</subject><subject>Blood</subject><subject>Enterobacter</subject><subject>Enterobacteriacae</subject><subject>Enterobacteriaceae</subject><subject>Enterococcus</subject><subject>Epidemiology</subject><subject>Klebsiella</subject><subject>Pathogens</subject><subject>Pseudomonas</subject><subject>Streptococcus</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqVkctu1DAUhi0EEkPhHSx1w4IUO77kRKzQiELFiIu4LNhYjmNTD5m4tZ2qXfHqnFEQQuxYHNn69Z3rT8gpZ2ecC_3cZnc5xuIu4zQ2LeNtIxgHUGeg75ENlxpQlfI-2TDGRNMDwEPyqJQ9QxZAbMjPD7ZWn-dCU6CxpMlWX2ic6TClNFK3THXJqNh5xKhxiKlGR1GKpdrZeXqVU4gTIunGZxrijad33uby7FjFUixeo813tCz5e3R2orNPs634WeZYH5MHwU7FP_n9npAv568-b980u_evL7Yvd83Ae2gbZ0FwZl0YJPSK97pz4yiFYw4DglIsMAt6BK_AQghtp-SI24IQUrWiFyfk6VoXx71efKnmgHfz02RxnKUYrhTXrZLQInr6D7pPS55xOsMBryaZBIbUi5VyOZWSfTBXOR5wUcOZOZpj_jbHHM0xqzkGNGY3azZe0d_-SbX5h9Gd6JR593VrPn7add_OpTZvkdcrPxz2_9XoFypdqNQ</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Valappil, S</creator><creator>Demertzi, E</creator><creator>Grant, M</creator><creator>Chuang, S</creator><creator>Ogundipe, E</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7QL</scope><scope>C1K</scope></search><sort><creationdate>201205</creationdate><title>Patterns of isolates in blood cultures and antibiotic resistance profiles over five years, in a tertiary surgical neonatal unit</title><author>Valappil, S ; Demertzi, E ; Grant, M ; Chuang, S ; Ogundipe, E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1982-ca8310acfb48951967cdd43c0c3c08f550f0a86d8e58a8ff2754d888833452393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Antibiotic resistance</topic><topic>Antibiotics</topic><topic>Blood</topic><topic>Enterobacter</topic><topic>Enterobacteriacae</topic><topic>Enterobacteriaceae</topic><topic>Enterococcus</topic><topic>Epidemiology</topic><topic>Klebsiella</topic><topic>Pathogens</topic><topic>Pseudomonas</topic><topic>Streptococcus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Valappil, S</creatorcontrib><creatorcontrib>Demertzi, E</creatorcontrib><creatorcontrib>Grant, M</creatorcontrib><creatorcontrib>Chuang, S</creatorcontrib><creatorcontrib>Ogundipe, E</creatorcontrib><collection>Istex</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Education Periodicals</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Education Collection</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Education Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Valappil, S</au><au>Demertzi, E</au><au>Grant, M</au><au>Chuang, S</au><au>Ogundipe, E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of isolates in blood cultures and antibiotic resistance profiles over five years, in a tertiary surgical neonatal unit</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2012-05</date><risdate>2012</risdate><volume>97</volume><issue>Suppl 1</issue><spage>A34</spage><epage>A35</epage><pages>A34-A35</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>Background Neonatal sepsis with bacteraemia causes high morbidity and mortality. Early empirical antibiotics are essential to reduce this. Antibiotic policies are based on local epidemiological data of pathogens and resistance profiles. Objective Identify bacteraemia pathogens and antibiotic resistance rates including incidence of Extended Spectrum Beta Lactamase producing Enterobacteriacae, thus informing policy. Compare pathogen profile in Medical versus Surgical admissions. Methods Positive blood cultures from January 2006 to December 2010 were analysed. False positives were excluded using concurrent laboratory results (from date of positive culture to 10 days after) if CRP<10, WCC<22 & Platelets>100, along with clinical data from electronic database (SEND) for secondary outcomes. Results The average positive blood cultures for all 5 years was 15.1%, of which Cogulase negative Staphylococci (clinically significant only) was 48.8%, Enterobacteriaceae was 21.8%, group B streptococcus 2.9% and the rest were S Aureus, Enterobacter and others. The Cefotoxime resistant Enterobacteriaceae were 18.9%. Tazocin resistance was 36.7%, and Gentamycin resistance (excluding Pseudomonas) was 2.1%. Commonest pathogens in early onset sepsis (<48 hours age) n=28 (6.6%), were GBS (35%) & coliforms (23%), and in late onset sepsis (n=392) CoNS (48%), Enterococcus (9.1%) and Klebsiella (6.8%). No candidaemia in 2009-10, despite surgical antibiotics. There was no significant differences in pathogens between surgical (n=232) and medical (n=188) infants. In 5 years, 11 babies died during episodes of sepsis and 2 term babies had cerebral bleed, reflecting the bane of sepsis. Conclusion Pathogens and resistance patterns were stable with a decreasing trend in Tazocin resistance. Tazocin with Gentamicin (resistance 2.1%) is a reasonable 2nd line for late onset sepsis. ESBL rate was 18.9% compared with BSPI National surveillance data (26%), probably attributable to low Cephalosporin use. Since pathogen profiles change, it is important to review epidemiology periodically.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><doi>10.1136/archdischild-2012-301885.86</doi></addata></record> |
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| subjects | Antibiotic resistance Antibiotics Blood Enterobacter Enterobacteriacae Enterobacteriaceae Enterococcus Epidemiology Klebsiella Pathogens Pseudomonas Streptococcus |
| title | Patterns of isolates in blood cultures and antibiotic resistance profiles over five years, in a tertiary surgical neonatal unit |
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