Abstract
Sepsis is one of the major causes of neonatal deaths in India and worldwide. Pathogens encountered in neonatal sepsis vary worldwide; reports from developing countries more commonly show Gram negative organisms, most common being Acinetobacter spp., Klebsiella spp. and Escherichia coli. Recent studies show that the incidence of antimicrobial resistance, to third generation cephalosporins and carbapenems, has been on a rise. Because of widespread antimicrobial resistance, ‘Higher’ or ‘Reserve’ antibiotics are increasingly being used as first/second line antibiotics. In the past decade, there has been a resurgence in the use of colistin as a result of Extended-spectrum β-lactamase (ESBL)- producing Enterobacteriaceae and carbapenem resistant Enterobacteriaceae (CRE), which retain susceptibility only to colistin. The increasing burden of drug resistant Gram negative organisms, particularly Acinetobacter spp., Klebsiella spp., and E. coli might pose a formidable threat in coming years.
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References
Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385:430–40.
Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67:169–74.
Karthikeyan G, Premkumar K. Neonatal sepsis: Staphylococcus aureus as the predominant pathogen. Indian J Pediatr. 2001;68:715–7.
Investigators of the Delhi Neonatal Infection Study (DeNIS) collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Glob Health. 2016;4:e752–60.
Kumar A, Randhawa VS, Nirupam N, Rai Y, Saili A. Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India. J Infect Dev Countries. 2014;8:1049–54.
Fuchs A, Bielicki J, Mathur S, Sharland M, Van Den Anker JN. Antibiotic use for sepsis in neonates and children: 2016 evidence update. WHO Reviews 2016.
Cohen-Wolkowiez M, Moran C, Benjamin DK, et al. Early and late onset sepsis in late preterm infants. Pediatr Infect Dis J. 2009;28:1052.
Principi N, Esposito S. Antimicrobial stewardship in paediatrics. BMC Infect Dis. 2016;16:424.
Nation RL, Li J. Colistin in the 21st century. Curr Opin Infect Dis. 2009;22:535.
Michalopoulos AS, Tsiodras S, Rellos K, Mentzelopoulos S, Falagas ME. Colistin treatment in patients with ICU-acquired infections caused by multiresistant gram-negative bacteria: the renaissance of an old antibiotic. Clin Microbiol Infect. 2005;11:115–21.
Iosifidis E, Antachopoulos C, Ioannidou M, et al. Colistin administration to pediatric and neonatal patients. Eur J Pediatr. 2010;169:867–74.
Cakir U, Alan S, Zeybek C, et al. Acquired bartter-like syndrome associated with colistin use in a preterm infant. Ren Fail. 2013;35:411–3.
Vardakas KZ, Mavroudis AD, Georgiou M, Falagas ME. Intravenous colistin combination antimicrobial treatment vs. monotherapy: a systematic review and meta-analysis. Int J Antimicrob Agents. 2018;51:535–47.
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Dudeja, S. Neonatal Sepsis: Treatment of Neonatal Sepsis in Multidrug-Resistant (MDR) Infections: Part 2. Indian J Pediatr 87, 122–124 (2020). https://doi.org/10.1007/s12098-019-03152-7
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DOI: https://doi.org/10.1007/s12098-019-03152-7