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Antibiotics
Special Issues
Antibiotics and Neonatal Sepsis: Challenges and Opportunities
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Antibiotics and Neonatal Sepsis: Challenges and Opportunities

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 10712

Special Issue Editors

Prof. Dr. Gabriel Dimitriou

E-Mail Website
Guest Editor
Professor of Pediatrics & Neonatology, Head of the Department of Pediatrics_NICU, PICU, University General Hospital of Patras, School of Medicine, University of Patras, 26504 Patras, Greece
Interests: pediatrics; neonatology; neonatal lung; respiratory muscles; neonatal infections
Special Issues, Collections and Topics in MDPI journals
Dr. Despoina Gkentzi

E-Mail Website
Guest Editor
Department of Paediatrics, Patras Medical School, University General Hospital of Patras, 26504 Ρίο, Greece
Interests: neonatal infections; public health; vaccines
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Neonatal sepsis can present with non-specific symptoms and signs, which may also be due to non-infectious causes. The absence of findings from a physical examination of a newborn does not exclude the possibility of infection, and there are no laboratory tests to confirm or exclude the possibility of the early stages of potential bacteraemia with certainty. Therefore, the empirical use of antimicrobials is a common and widely accepted practice in the neonatologist’s daily routine, with antimicrobials being the most commonly prescribed drugs in Neonatal Intensive Care Units (NICUs). However, the prolonged and occasionally unnecessary use of broad-spectrum antimicrobials in NICUs increases the risk of Candida colonization and invasive infection, necrotizing enterocolitis, late-onset neonatal sepsis, and death. Recently published data also suggest the development of long-term effects of the overuse of antimicrobials given in the neonatal period through their effect on the intestinal microbiome, including the development of atopic diseases. Neonatal infections from multidrug-resistant strains are associated with increased mortality, excessive cost, prolonged hospitalization, and therapeutic challenges. Additionally, the colonization of newborns with these pathogens makes them a potential source of nosocomial outbreaks. For all of the above reasons, the rational use of antimicrobials in NICUs is imperative. Moreover, data on the pharmakinetics and pharmakodynamics of certain antibiotics in neonates are lacking, which makes their use all the more challenging.

We therefore invite you to submit your articles (research or review) in this field, focusing on the wiser use of these types of medication in the vulnerable neonatal population.

Prof. Dr. Gabriel Dimitriou
Prof. Dr. Despoina Gkentzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Antibiotics
  • Neonatal sepsis
  • Early onset neonatal sepsis
  • Late onset neonatal sepsis
  • Pharmacokinetics
  • Pharmakodynamics
  • Diagnosis
  • Antimicrobial Stewardship

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Published Papers (4 papers)

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Research

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9 pages, 255 KiB  
Article
Persistent Coagulase-Negative Staphylococcal Bacteremia in Neonates: Clinical, Microbiological Characteristics and Changes within a Decade
by Venetia Bellou, Despoina Gkentzi, Nikolaos Giormezis, Aggeliki Vervenioti, Iris Spiliopoulou and Gabriel Dimitriou
Antibiotics 2022, 11(6), 765; https://doi.org/10.3390/antibiotics11060765 - 2 Jun 2022
Cited by 6 | Viewed by 2241
Abstract
Atypical outbreaks of persistent coagulase-negative staphylococci (CoNS) bacteremias, defined as three or more consecutive positive blood cultures with the same CoNS species, at least 48 h apart, have been reported in neonatal intensive-care units (NICUs). Our aim was to describe the profile of [...] Read more.
Atypical outbreaks of persistent coagulase-negative staphylococci (CoNS) bacteremias, defined as three or more consecutive positive blood cultures with the same CoNS species, at least 48 h apart, have been reported in neonatal intensive-care units (NICUs). Our aim was to describe the profile of these cases in our NICU over a two-year period with the objective of assessing possible changes within a decade. Demographics, clinical and microbiological data were recorded for all CoNS bacteremias in our tertiary NICU during 2016–2017 and compared with the results of the same study in 2006–2007. Fifty-six cases of CoNS sepsis were recorded. Fourteen (25%) of them were persistent. There were no significant differences in demographic and clinical characteristics between cases with persistent vs. non-persistent bacteremia. Staphylococcus epidermidis was the most common species. In logistic regression analysis, biofilm production (β = 2.464, p = 0.04) was the most significant determinant for the development of persistent CoNS bacteremia. Our isolates were less likely to produce biofilm and carry ica operon as compared to those of 2006–2007. The cases of persistent CoNS sepsis have decreased within a decade, which could be attributed to the implementation of intensive infection control practices. Biofilm production remains the most important risk factor. Full article
(This article belongs to the Special Issue Antibiotics and Neonatal Sepsis: Challenges and Opportunities)
13 pages, 833 KiB  
Article
Antibiotic Exposure, Common Morbidities and Main Intestinal Microbial Groups in Very Preterm Neonates: A Pilot Study
by Nicole Bozzi Cionci, Laura Lucaccioni, Elisa Pietrella, Monica Ficara, Caterina Spada, Paola Torelli, Luca Bedetti, Licia Lugli, Diana Di Gioia and Alberto Berardi
Antibiotics 2022, 11(2), 237; https://doi.org/10.3390/antibiotics11020237 - 12 Feb 2022
Cited by 7 | Viewed by 2555
Abstract
Prematurity exposes newborns to increased risks of infections and it is associated with critical morbidities. Preterm infants often require antibiotic therapies that can affect the correct establishment of gut microbiota. The aim of this study was to investigate targeted intestinal bacteria in preterm [...] Read more.
Prematurity exposes newborns to increased risks of infections and it is associated with critical morbidities. Preterm infants often require antibiotic therapies that can affect the correct establishment of gut microbiota. The aim of this study was to investigate targeted intestinal bacteria in preterm neonates with common morbidities and receiving antibiotic treatments of variable duration. Stool samples were collected after birth, at 15, 30 and 90 days of life. qPCR quantification of selected microbial groups (Bifidobacterium spp., Bacteroides fragilis group, Enterobacteriaceae, Clostridium cluster I and total bacteria) was performed and correlation between their levels, the duration of antibiotic treatment and different clinical conditions was studied. An increasing trend over time was observed for all microbial groups, especially for Bifdobacterium spp. Prolonged exposure to antibiotics in the first weeks of life affected Clostridium and B. fragilis levels, but these changes no longer persisted at 90 days of life. Variations of bacterial counts were associated with the length of hospital stay, feeding and mechanical ventilation. Late-onset sepsis and patent ductus arteriosus reduced the counts of Bifidobacterium, whereas B. fragilis was influenced by compromised respiratory conditions. This study can be a start point for the identification of microbial biomarkers associated with some common morbidities and tailored strategies for a healthy microbial development. Full article
(This article belongs to the Special Issue Antibiotics and Neonatal Sepsis: Challenges and Opportunities)
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Review

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21 pages, 691 KiB  
Review
Use of Newer and Repurposed Antibiotics against Gram-Negative Bacteria in Neonates
by Angeliki Kontou, Maria Kourti, Elias Iosifidis, Kosmas Sarafidis and Emmanuel Roilides
Antibiotics 2023, 12(6), 1072; https://doi.org/10.3390/antibiotics12061072 - 19 Jun 2023
Cited by 8 | Viewed by 2821
Abstract
Antimicrobial resistance has become a significant public health problem globally with multidrug resistant Gram negative (MDR-GN) bacteria being the main representatives. The emergence of these pathogens in neonatal settings threatens the well-being of the vulnerable neonatal population given the dearth of safe and [...] Read more.
Antimicrobial resistance has become a significant public health problem globally with multidrug resistant Gram negative (MDR-GN) bacteria being the main representatives. The emergence of these pathogens in neonatal settings threatens the well-being of the vulnerable neonatal population given the dearth of safe and effective therapeutic options. Evidence from studies mainly in adults is now available for several novel antimicrobial compounds, such as new β-lactam/β-lactamase inhibitors (e.g., ceftazidime–avibactam, meropenem–vaborbactam, imipenem/cilastatin–relebactam), although old antibiotics such as colistin, tigecycline, and fosfomycin are also encompassed in the fight against MDR-GN infections that remain challenging. Data in the neonatal population are scarce, with few clinical trials enrolling neonates for the evaluation of the efficacy, safety, and dosing of new antibiotics, while the majority of old antibiotics are used off-label. In this article we review data about some novel and old antibiotics that are active against MDR-GN bacteria causing sepsis and are of interest to be used in the neonatal population. Full article
(This article belongs to the Special Issue Antibiotics and Neonatal Sepsis: Challenges and Opportunities)
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21 pages, 432 KiB  
Review
Predictive Scores for Late-Onset Neonatal Sepsis as an Early Diagnostic and Antimicrobial Stewardship Tool: What Have We Done So Far?
by Georgia Anna Sofouli, Aimilia Kanellopoulou, Aggeliki Vervenioti, Gabriel Dimitriou and Despoina Gkentzi
Antibiotics 2022, 11(7), 928; https://doi.org/10.3390/antibiotics11070928 - 10 Jul 2022
Cited by 10 | Viewed by 2501
Abstract
Background: Late-onset neonatal sepsis (LOS) represents a significant cause of morbidity and mortality worldwide, and early diagnosis remains a challenge. Various ‘sepsis scores’ have been developed to improve early identification. The aim of the current review is to summarize the current knowledge on [...] Read more.
Background: Late-onset neonatal sepsis (LOS) represents a significant cause of morbidity and mortality worldwide, and early diagnosis remains a challenge. Various ‘sepsis scores’ have been developed to improve early identification. The aim of the current review is to summarize the current knowledge on the utility of predictive scores in LOS as a tool for early sepsis recognition, as well as an antimicrobial stewardship tool. Methods: The following research question was developed: Can we diagnose LOS with accuracy in neonates using a predictive score? A systematic search was performed in the PubMed database from 1982 (first predictive score published) to December 2021. Results: Some (1352) articles were identified—out of which, 16 were included in the review. Eight were original scores, five were validations of already existing scores and two were mixed. Predictive models were developed by combining a variety of clinical, laboratory and other variables. The majority were found to assist in early diagnosis, but almost all had a limited diagnostic accuracy. Conclusions: There is an increasing need worldwide for a simple and accurate score to promptly predict LOS. Combinations of the selected parameters may be helpful, but until now, a single score has not been proven to be comprehensive. Full article
(This article belongs to the Special Issue Antibiotics and Neonatal Sepsis: Challenges and Opportunities)
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