Empiric therapy with vancomycin in the neonatal intensive care unit: let's “get smart” globally!

Sánchez, Pablo J.; Moallem, Mohannad; Cantey, Joseph B.; Milton, Avante D; Michelow, Ian C.

doi:10.1016/j.jped.2016.06.001

Cited by 12 publications

(4 citation statements)

References 34 publications

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“…Several studies have shown that not using vancomycin in the initial empirical antibiotic regimen does not increase mortality, duration of bacteremia, and complications attributed to late neonatal sepsis. 29 , 30 , 31 , 32 …”

Section: Antibiotic Therapymentioning

confidence: 99%

The challenges of neonatal sepsis management

Procianoy

Silveira

2020

Jornal de Pediatria

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Section: Antibiotic Therapymentioning

confidence: 99%

The challenges of neonatal sepsis management

Procianoy

Silveira

2020

Jornal de Pediatria

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“…7 , 8 Vancomycin is a drug of choice for the treatment of methicillin-resistant CoNS associated with neonatal infections. 9 However, in recent years, there are increasing reports of vancomycin resistance among staphylococci isolates, and the exact mechanism of resistance has not yet been completely understood. 10 …”

Section: Introductionmentioning

confidence: 99%

Application of <em>tuf</em> gene sequence analysis for the identification of species of coagulase-negative staphylococci in clinical samples and evaluation of their antimicrobial resistance pattern

Khosravi¹,

Roointan²,

Montazeri³

et al. 2018

IDR

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IntroductionCoagulase-negative staphylococci (CoNS) are normal inhabitants of human skin and mucous membranes. However, CoNS represent one of the major nosocomial pathogens, especially in immunocompromised patients. The increasing incidence of CoNS and mainly methicillin-resistant strains underlines the need for an accurate identification of Staphylococcus isolates at the species level. Analysis of the tuf gene proved to be an accurate tool for the species identification of CoNS. The aims of this study were to identify the CoNS species by tuf gene-based polymerase chain reaction method and sequencing, and to determine the frequency of CoNS clinical isolates resistant to methicillin (MRCoNS) and other antibiotics.MethodsA total of 200 staphylococci isolates were collected from various clinical samples. Phenotyping methods were used for initial identification followed by polymerase chain reaction amplification of tuf gene with subsequent sequencing. The phylogenetic relationships among species were analyzed using the neighbor-joining method based on the partial gene sequence of tuf. Microbroth dilution test was used for screening methicillin resistance, and disk diffusion susceptibility testing was performed for evaluation of antibiotic resistance among the isolates.ResultsIn the present study, 125 isolates were identified as CoNS; among them, Staphylococcus epidermidis 54(43.2%) and Staphylococcus haemolyticus 50 (40.0%) were demonstrated as the most prevalent species. Resistance to methicillin was detected in 54.4% of the CoNS based on microbroth dilution method. In disk diffusion susceptibility testing, the greatest resistance of CoNS was demonstrated for cefoxitin (65.4%), cotrimethoxazole (54.4%), and clindamycin (49.6%), while daptomycin (87.2%) and linezolid (83.2%) showed the greatest effectiveness for CoNS isolates.ConclusionOur results confirmed the predominance of S. epidermidis and S. haemolyticus among CoNS isolates. The high prevalence of MRCoNS strains is a serious concern and strongly suggests the need for control program measures in our hospitals in order to reduce MRCoNS infections, especially in immunocompromised patients.

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“…In the neonatal intensive care unit (ICU), there is routine and frequent use of vancomycin. Sánches et al 18 point out that vancomycin is used empirically in ICUs, making its use inappropriate. In the 1980s, antimicrobial management programs were introduced with the aim of reducing unnecessary therapies.…”

Section: Discussionmentioning

confidence: 99%