Evidence map›Paper›PMID 31446393›Full record

Observational studyArchives of disease in childhood2020

Towards understanding global patterns of antimicrobial use and resistance in neonatal sepsis: insights from the NeoAMR network.

Grace Li, Julia Anna Bielicki, A S M Nawshad Uddin Ahmed, Mohammad Shahidul Islam, Eitan Naaman Berezin, Clery B Gallacci, Ruth Guinsburg, Carlos Eduardo da Silva Figueiredo, Rosilene Santarone Vieira, Andre Ricardo Silva and 53 more

Erratum issuedOpen access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Archives of disease in childhood, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 61 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 2 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 116 citations in OpenAlex.

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  10. External Evaluation of a Plasma and Cerebrospinal Fluid Population Pharmacokinetics Model of Meropenem in Infants.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

63 authors at 20 institutions in 13 countries.

Grace LiPaediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George's, University of London, London, UK.ORCID 0000-0002-6661-0421
Julia Anna BielickiPaediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George's, University of London, London, UK.
A S M Nawshad Uddin AhmedChild Health Research Foundation, Dhaka Shishu Hospital, Dhaka, Bangladesh.
Mohammad Shahidul IslamChild Health Research Foundation, Dhaka Shishu Hospital, Dhaka, Bangladesh.
Eitan Naaman BerezinSanta Casa Medical School, São Paulo, Brazil.
Clery B GallacciSanta Casa Medical School, São Paulo, Brazil.
Ruth GuinsburgEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.ORCID 0000-0003-1967-9861
Carlos Eduardo da Silva FigueiredoInstituto Fernandes Figueira, Rio de Janeiro, Brazil.
Rosilene Santarone VieiraInstituto Fernandes Figueira, Rio de Janeiro, Brazil.
Andre Ricardo SilvaFederal Fluminense University, Rio de Janeiro, Brazil.
Cristiane TeixeiraProntobaby Children's Hospital, Rio de Janeiro, Brazil.
Paul TurnerCambodia Oxford Medical Research Unit, Siem Reap, Cambodia.
Ladin NhanAngkor Hospital for Children, Siem Reap, Cambodia.
Jaime OrregoFundación Valle del Lili, Santiago de Cali, Colombia.
Paola Marsela PérezFundación Valle del Lili, Santiago de Cali, Colombia.
Lifeng QiShenzhen Children's Hospital, Shenzhen, China.
Vassiliki PapaevangelouThird Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece.
Pinelope TriantafyllidouAttikon University General Hospital, Athens, Greece.
Elias IosifidisSchool of Health Sciences, Aristotle University, Thessaloniki, Greece.
Emmanuel RoilidesSchool of Health Sciences, Aristotle University, Thessaloniki, Greece.
Kosmas SarafidisSchool of Health Sciences, Aristotle University, Thessaloniki, Greece.
Dasaratha Ramaiah JinkaDepartment of Paediatrics, Rural Development Trust Hospital, Bathalapalli, India.
Raghuprakash Reddy NayakantiDepartment of Paediatrics, Rural Development Trust Hospital, Bathalapalli, India.
Praveen KumarPaediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Vikas GautamPaediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Vinayagam PrakashInstitute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai, India.
Arasar SeeralarInstitute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai, India.
Srinivas MurkiDepartment of Neonatology, Fernandez Hospital, Hyderabad, India.
Hemasree KandrajuDepartment of Neonatology, Fernandez Hospital, Hyderabad, India.
Sanjeev SinghAmrita Institute of Medical Sciences, Kochi, India.
Anil KumarAmrita Institute of Medical Sciences, Kochi, India.
Leslie LewisKasturba Medical College, Manipal, India.
Jayashree PukayasthaKasturba Medical College, Manipal, India.
Sushma NangiaLady Hardinge Medical College, New Delhi, India.ORCID 0000-0002-7664-2259
Yogesha K NLady Hardinge Medical College, New Delhi, India.
Suman ChaurasiaAll India Institute of Medical Sciences, New Delhi, India.
Harish ChellaniVardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Stephen ObaroInternational Foundation Against Infectious Disease in Nigeria, Omaha, Nebraska, USA.
Angela DramowskiDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Adrie BekkerDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Andrew WhitelawDivision of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Reenu ThomasUniversity of the Witwatersrand, Johannesburg, South Africa.
Sithembiso Christopher VelaphiUniversity of the Witwatersrand, Johannesburg, South Africa.
Daynia Elizabeth BallotUniversity of the Witwatersrand, Johannesburg, South Africa.
Trusha NanaUniversity of the Witwatersrand, Johannesburg, South Africa.
Gary ReubensonUniversity of the Witwatersrand, Johannesburg, South Africa.
Joy FredericksUniversity of the Witwatersrand, Johannesburg, South Africa.
Suvaporn AnugulruengkittChulalongkorn University, Bangkok, Thailand.
Anongnart SirisubChulalongkorn University, Bangkok, Thailand.
Pimol WongFaculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sorasak LochindaratQueen Sirikit National Institute of Child Health, Bangkok, Thailand.
Suppawat BoonkasidechaQueen Sirikit National Institute of Child Health, Bangkok, Thailand.
Kanchana PreedisripipatChiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Tim R CresseyChiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Pongsatorn PaopongsawanDepartment of Paediatrics, Khon Kaen University, Khon Kaen, Thailand.
Pagakrong LumbiganonDepartment of Paediatrics, Khon Kaen University, Khon Kaen, Thailand.
Dounghatai PongpanutPhayao Hospital, Phayao, Thailand.
Pra-Ornsuda SukrakanchanaPhayao Hospital, Phayao, Thailand.
Philippa MusokePaediatrics and Child Health, Makerere University, Kampala, Kampala, Uganda.
Linus OlsonKarolinska Institute in collaboration with Vietnam National Children's Hospital within Training and Research Academic Collaboration (TRAC) Sweden - Vietnam, Hanoi, Vietnam.
Mattias LarssonKarolinska Institute in collaboration with Vietnam National Children's Hospital within Training and Research Academic Collaboration (TRAC) Sweden - Vietnam, Hanoi, Vietnam.
Paul T HeathPaediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George's, University of London, London, UK.
Michael SharlandPaediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St George's, University of London, London, UK msharlan@sgul.ac.uk.
University of the Witwatersrand · ZASt George's, University of London · GBAristotle University of Thessaloniki · GRAmrita Institute of Medical Sciences and Research Centre · INBangladesh Shishu (Children) Hospital & Institute · BDChiangRai Prachanukroh Hospital · THChulalongkorn University · THFernandez Hospital · INFundación Valle del Lili · COGovernment General Hospital · INKasturba Medical College, Manipal · INKhon Kaen University · THLady Hardinge Medical College · INMedical Trust Hospital · INPost Graduate Institute of Medical Education and Research · INQueen Sirikit National Institute of Child Health · THStellenbosch University · ZAUniversity of Phayao · THVietnam National Children's Hospital · VNAll India Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo gain an understanding of the variation in available resources and clinical practices between neonatal units (NNUs) in the low-income and middle-income country (LMIC) setting to inform the design of an observational study on the burden of unit-level antimicrobial resistance (AMR).

designA web-based survey using a REDCap database was circulated to NNUs participating in the Neonatal AMR research network. The survey included questions about NNU funding structure, size, admission rates, access to supportive therapies, empirical antimicrobial guidelines and period prevalence of neonatal blood culture isolates and their resistance patterns.

setting39 NNUs from 12 countries. PATIENTS: Any neonate admitted to one of the participating NNUs.

interventionsThis was an observational cohort study.

resultsThe number of live births per unit ranged from 513 to 27 700 over the 12-month study period, with the number of neonatal cots ranging from 12 to 110. The proportion of preterm admissions <32 weeks ranged from 0% to 19%, and the majority of units (26/39, 66%) use Essential Medicines List 'Access' antimicrobials as their first-line treatment in neonatal sepsis. Cephalosporin resistance rates in Gram-negative isolates ranged from 26% to 84%, and carbapenem resistance rates ranged from 0% to 81%. Glycopeptide resistance rates among Gram-positive isolates ranged from 0% to 45%.

conclusionAMR is already a significant issue in NNUs worldwide. The apparent burden of AMR in a given NNU in the LMIC setting can be influenced by a range of factors which will vary substantially between NNUs. These variations must be considered when designing interventions to improve neonatal mortality globally.

Indexed as

Anti-Infective AgentsDeveloping CountriesDrug Resistance, BacterialGlobal HealthHumansInfant, NewbornNeonatal SepsisSurveys and QuestionnairesAnti-Infective Agentsantimicrobial resistanceneonatal sepsis

Identifiers

PMID31446393
PMCPMC6951234
OpenAlexW2969858855

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.