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Vancomycin and neonate

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https://www.readbyqxmd.com/read/28421643/empiric-antibiotic-regimens-for-neonatal-sepsis-in-australian-and-new-zealand-neonatal-intensive-care-units
#1
Jeremy P Carr, David P Burgner, Rohan S Hardikar, Jim P Buttery
AIM: Neonatal sepsis remains an important cause of morbidity and mortality, and requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short- and long-term consequences. There is no consensus regarding empirical antimicrobial regimens. METHODS: The study included a survey of empiric antimicrobial regimens in all tertiary neonatal intensive care units in Australia and New Zealand in 2013-2014...
April 19, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28407067/evaluation-of-a-second-sign-process-for-antimicrobial-prior-authorization
#2
Aimee M Dassner, Jennifer E Girotto
Background.: A second-sign prospective restriction of select broad-spectrum antimicrobials was fully implemented in January 2015 as a pediatric antimicrobial stewardship program (ASP) initiative to help ensure the most appropriate empiric use of ceftaroline, cefepime, fidaxomicin, linezolid, and vancomycin (intravenous). The objective of this evaluation is to assess the effectiveness of a forced second-sign process in the electronic medical record as a pediatric ASP strategy. We anticipated that the second-sign process for antibiotics would increase the appropriateness of empiric antibiotic use, as defined by preapproved criteria, clinical pathways, national guidelines, and pediatric-specific infectious diseases reference texts, while not causing significant delay in the initial administration of antibiotic therapy...
April 12, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28373147/vancomycin-treatment-is-a-risk-factor-for-vancomycin-nonsusceptible-staphylococcus-capitis-sepsis-in-preterm-neonates
#3
Marine Butin, Jean-Philippe Rasigade, Fabien Subtil, Patricia Martins-Simões, Charlotte Pralong, Anne-Marie Freydière, François Vandenesch, Sylvestre Tigaud, Jean-Charles Picaud, Frédéric Laurent
OBJECTIVE: Multiresistant, vancomycin-nonsusceptible Staphylococcus capitis is an emerging cause worldwide of late-onset sepsis (LOS) in preterm neonates. The pathophysiology and risk factors for S. capitis-related LOS are poorly understood but we hypothesized that S. capitis LOS follows translocation from the gut microbiota rather than catheter invasion. The objective of this study was to investigate the risk factors of S. capitis LOS and gut colonization. METHODS: We conducted a prospective monocentric cohort study of patients hospitalized in a tertiary care unit (Lyon, France) from June 2011 to January 2012...
March 31, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28350900/gram-positive-bacterial-infections-research-priorities-accomplishments-and-future-directions-of-the-antibacterial-resistance-leadership-group
#4
Sarah B Doernberg, Thomas P Lodise, Joshua T Thaden, Jose M Munita, Sara E Cosgrove, Cesar A Arias, Helen W Boucher, G Ralph Corey, Franklin D Lowy, Barbara Murray, Loren G Miller, Thomas L Holland
Antimicrobial resistance in gram-positive bacteria remains a challenge in infectious diseases. The mission of the Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG) is to advance knowledge in the prevention, management, and treatment of these challenging infections to improve patient outcomes. Our committee has prioritized projects involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) due to the scope of the medical threat posed by these pathogens...
March 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28339914/infant-colonization-with-methicillin-resistant-staphylococcus-aureus-or-vancomycin-resistant-enterococci-preceding-neonatal-intensive-care-unit-discharge
#5
Sarah A Clock, Haomiao Jia, Sameer Patel, Yu-Hui Ferng, Luis Alba, Susan Whittier, Patricia DeLaMora, Setareh Tabibi, Jeffrey Perlman, David Paul, Theoklis Zaoutis, Elaine Larson, Lisa Saiman
Rates of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) were determined for 1320 infants within 7 days of neonatal intensive care unit discharge. Overall, 4% and 1% of the infants were colonized with MRSA or VRE, respectively. Predictors identified in fixed-effects models were surgery during hospitalization (for MRSA colonization) and prolonged antimicrobial treatment (for VRE colonization).
March 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28333257/comparative-effectiveness-of-linezolid-versus-vancomycin-as-definitive-antibiotic-therapy-for-heterogeneously-resistant-vancomycin-intermediate-coagulase-negative-staphylococcal-central-line-associated-bloodstream-infections-in-a-neonatal-intensive-care-unit
#6
A C Blanchard, E Fortin, C Laferrière, I Goyer, A Moussa, J Autmizguine, C Quach
Objectives: Heterogeneously resistant vancomycin-intermediate coagulase-negative staphylococci (hVICoNS) are emerging pathogens causing central-line-associated bloodstream infections (CLABSIs) in neonatal intensive care unit (NICU) patients. Given the burden of disease associated with CLABSI and the current lack of therapeutic guidelines, we aimed to compare the effectiveness of linezolid versus vancomycin used as the definitive antibiotic therapy for hVICoNS CLABSI. Methods: We performed a retrospective cohort study of infants with hVICoNS CLABSI from a single NICU between 2009 and 2014, treated with either linezolid or vancomycin as definitive antibiotic therapy...
March 3, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28322345/nursing-staff-fluctuation-and-pathogenic-burden-in-the-nicu-effective-outbreak-management-and-the-underestimated-relevance-of-non-resistant-strains
#7
Kai O Hensel, Rhea van den Bruck, Ingo Klare, Michael Heldmann, Beniam Ghebremedhin, Andreas C Jenke
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r(2) = 0.95, p = 0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28287001/transplacental-passage-of-vancomycin
#8
Craig V Towers, Beth Weitz
OBJECTIVE: To evaluate a larger number of patients receiving a vancomycin-dosing regimen of 20 mg/kg IV every 8 h for Group B streptococcus (GBS) chemoprophylaxis and analyze maternal and neonatal cord blood levels at delivery. METHODS: We prospectively enrolled every mother that entered labor with a positive GBS culture and a high-risk penicillin allergy with resistance to clindamycin or unknown sensitivity. Maternal and cord blood vancomycin levels were obtained at delivery...
March 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28272077/changing-trend-in-bacterial-etiology-and-antibiotic-resistance-in-sepsis-of-intramural-neonates-at-a-tertiary-care-hospital
#9
M P Roy, M Bhatt, V Maurya, S Arya, R Gaind, H K Chellani
BACKGROUND: Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates. MATERIALS AND METHODS: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999-2014, divided into five phases...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28187757/the-association-between-vancomycin-trough-concentrations-and-acute-kidney-injury-in-the-neonatal-intensive-care-unit
#10
Vidit Bhargava, Michael Malloy, Rafael Fonseca
BACKGROUND: Vancomycin has recently gained popularity as an empiric therapy for late onset sepsis in the NICU. Changes in resistance patterns in common organisms has resulted in targeting higher trough concentrations of vancomycin. Consequently, an increase in vancomycin associated nephrotoxicity has been speculated. The objective of this study is to compare the incidence of acute kidney injury (AKI) in neonates with serum vancomycin trough concentrations less than 10 mg/L, 10-15 mg/L, or greater than 15 mg/L...
February 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28178052/fecal-microbiota-transplant-for-clostridium-difficile-infection-in-a-pregnant-patient
#11
Bejan J Saeedi, Doree Gardner Morison, Colleen S Kraft, Tanvi Dhere
BACKGROUND: Clostridium difficile infection has been associated with negative outcomes in the general population and in pregnant patients. Fecal microbiota transplant has become the standard for treatment of recurrent as well as refractory C difficile infection. CASE: We present a case of a 28-year-old pregnant woman who presented with recurrent C difficile infection despite treatment with vancomycin and fidaxomicin and underwent a successful fecal microbiota transplant through colonoscopy at 18 weeks of gestation...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28161461/infectious-disease-exposures-and-outbreaks-at-a-south-african-neonatal-unit-with-review-of-neonatal-outbreak-epidemiology-in-africa
#12
A Dramowski, M Aucamp, A Bekker, S Mehtar
BACKGROUND: Hospitalized neonates are vulnerable to infection, with pathogen exposures occurring in utero, intrapartum, and postnatally. African neonatal units are at high risk of outbreaks owing to overcrowding, understaffing, and shared equipment. METHODS: Neonatal outbreaks attended by the paediatric infectious diseases and infection prevention (IP) teams at Tygerberg Children's Hospital, Cape Town (May 1, 2008 to April 30, 2016) are described, pathogens, outbreak size, mortality, source, and outbreak control measures...
February 1, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28143490/pathogenic-bacteria-distributions-and-drug-resistance-analysis-in-96-cases-of-neonatal-sepsis
#13
Huaifu Dong, Huiping Cao, Haiyan Zheng
BACKGROUND: This study aimed to summarize common pathogens and associated drug resistance in neonatal sepsis (NS). METHODS: Blood culture and drug sensitivity results from 96 NS cases treated from January 2010 to August 2014 were retrospectively analyzed. RESULTS: A total of 97 pathogenic bacteria were detected from these 96 NS cases; Gram-positive cocci accounted for 76.3% of the cases, among which 70.1% involved coagulase-negative staphylococcus (CONS), whereas Gram-negative bacilli and fungi accounted for 19...
February 1, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#14
REVIEW
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic (PK) alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacillin-tazobactam, tobramycin, vancomycin, and voriconazole is presented. PubMed (1966-July 2015) and Cochrane Library searches were performed using these key terms: children, pharmacokinetic, obesity, overweight, body mass index, ideal body weight, lean body weight, body composition, and specific antimicrobial drugs...
March 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28077242/outbreak-of-elizabethkingia-meningoseptica-sepsis-with-meningitis-in-a-well-baby-nursery
#15
I-C Tai, T-P Liu, Y-J Chen, R-I Lien, C-Y Lee, Y-C Huang
Between March and May 2012, three neonates born at a regional maternity hospital developed Elizabethkingia meningoseptica (previously Chryseobacterium meningosepticum) sepsis with meningitis aged <10 days, and were treated successfully with intravenous ciprofloxacin plus vancomycin or piperacillin-tazobactam for three to six weeks. Four (16.6%) of 24 environmental specimens obtained from the nursery and delivery room were positive for this organism. All of the clinical isolates and two isolates from storage boxes for pacifiers and pacifier covers were genetically identical...
November 30, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28017667/assessment-of-optimal-initial-dosing-regimen-with-vancomycin-pharmacokinetics-model-in-very-low-birth-weight-neonates
#16
Hideo Kato, Mao Hagihara, Naoya Nishiyama, Yusuke Koizumi, Hiroshige Mikamo, Katsuhiko Matsuura, Yuka Yamagishi
INTRODUCTION: Pharmacokinetic of vancomycin in very low birth weight neonates showed big variety, and limited data were available due to very minor population. These facts make it difficult to adjust its optimal initial dosage. Therefore, this study was to develop optimal dosing regimen of vancomycin in very low birth weight neonates. METHODS: Between 2010 and 2015, low birth weight neonates (≤1500 g) were included in a population pharmacokinetics analysis. Based on the pharmacokinetic parameters we estimated, we simulated individual blood concentrations of vancomycin and evaluated the probability of its pharmacokinetics/pharmacodynamics (PK/PD) target attainment, such as 24-h area under the concentration-time curve (AUC24)/MIC (≥400) and blood trough concentration (10-20 μg/mL), as primary measure for several dosing regimens by Monte Carlo simulation method...
December 22, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27931193/coagulase-negative-staphylococcal-sepsis-in-neonates-do-we-need-to-adapt-vancomycin-dose-or-target
#17
Helgi Padari, Kersti Oselin, Tõnis Tasa, Tuuli Metsvaht, Krista Lõivukene, Irja Lutsar
BACKGROUND: Despite differences in types of infection and causative organisms, pharmacokinetic-pharmacodynamic (PKPD) targets of vancomycin therapy derived from adult studies are suggested for neonates. We aimed to identify doses needed for the attainment of AUC/MIC > 400 and AUC/MIC > 300 in neonates with sepsis and correlate these targets with recommended doses and treatment outcome. METHODS: Neonates who had Vancomycin therapeutic drug monitoring (TDM) performed between January 1, 2010 and December 31, 2012 were studied...
December 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27892440/urinary-tract-infection-in-asymptomatic-newborns-with-prolonged-unconjugated-hyperbilirubunemia-a-hospital-based-observational-study-from-western-region-of-nepal
#18
T Malla, B Sathian, K Karmacharya Malla, S Adhikari
Background Urine culture is usually not a part of work-up for neonatal unconjugated hyperbilirubinemia; hence its prevalence remains unknown. Objective This study was done to determine the incidence of urinary tract infection (UTI) in asymptomatic newborns with prolonged unconjugated hyperbilirubinemia and to evaluate which other laboratory parameters are associated with UTIs. Method A prospective observational study where jaundiced newborns otherwise clinically well, were evaluated for UTI. The study was carried out in neonatal intensive care unit of Manipal Teaching Hospital, Pokhara from June 2012 -April 2013...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27849621/vancomycin-induced-thrombocytopenia-in-a-newborn
#19
Kunal Kalra, Hema Gupta Mittal, Arti Maria
Neonatal thrombocytopenia is common and is frequently seen in neonatal sepsis. Drug-induced thrombocytopenia is likely to be missed unless a high index of suspicion is present. Changing of antibiotics for assumed nonresolution of sepsis may lead to persistent thrombocytopenia in a neonate if drug-induced thrombocytopenia is missed. Vancomycin-induced neonatal thrombocytopenia is rarely described in scientific literature. We describe a newborn who was diagnosed with early onset sepsis and vancomycin-induced thrombocytopenia...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27790440/outstanding-prevalence-of-methicillin-resistant-staphylococcus-aureus-in-neonatal-omphalitis
#20
Mallika Sengupta, Sayantan Banerjee, Pritam Banerjee, Partha Guchhait
INTRODUCTION: Omphalitis is the infection of the umbilical cord stump, which can lead to septicaemia and significant neonatal morbidity and mortality. Very little data is available on the aetiology of neonatal omphalitis in India. AIM: To identify the causative agents of omphalitis in neonates and determine the antimicrobial susceptibility patterns of the isolates. MATERIALS AND METHODS: A prospective study was conducted at ESI-PGIMSR and ESIC Medical College, Joka, a tertiary care teaching hospital in Eastern India for a period of four months (from 1st January 2016 to 30th April 2016)...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
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