title: Neonatal infections in England: the NeonIN surveillance network.
abstract: BACKGROUND
  Neonatal infection is an important cause of morbidity and mortality. Neonatal infection surveillance networks are necessary for defining the epidemiology of infections and monitoring changes over time.
  
  
  METHODS
  Prospective multicentre surveillance using a web-based database.
  
  
  METHODS
  12 English neonatal units.
  
  
  METHODS
  Newborns admitted in 2006-2008, with positive blood, cerebrospinal fluid or urine culture and treated with antibiotics for at least 5 days.
  
  
  METHODS
  Incidence, age at infection, pathogens and antibiotic resistance profiles.
  
  
  RESULTS
  With the inclusion of coagulase negative Staphylococci (CoNS), the incidence of all neonatal infection was 8/1000 live births and 71/1000 neonatal admissions (2007-2008). The majority of infections occurred in premature (<37 weeks) and low birthweight (<2500 g) infants (82% and 81%, respectively). The incidence of early onset sepsis (EOS; ≤48 h of age) was 0.9/1000 live births and 9/1000 neonatal admissions, and group B Streptococcus (58%) and Escherichia coli (18%) were the most common organisms. The incidence of late onset sepsis (LOS; >48 h of age) was 3/1000 live births and 29/1000 neonatal admissions (7/1000 live births and 61/1000 admissions including CoNS) and the most common organisms were CoNS (54%), Enterobacteriaceae (21%) and Staphylococcus aureus (18%, 11% of which were methicillin resistant S aureus). Fungi accounted for 9% of LOS (72% Candida albicans). The majority of pathogens causing EOS (95%) and LOS (84%) were susceptible to commonly used empiric first line antibiotic combinations of penicillin/gentamicin and flucloxacillin/gentamicin, respectively (excluding CoNS).
  
  
  CONCLUSIONS
  The authors have established NeonIN in England and defined the current epidemiology of neonatal infections. These data can be used for benchmarking among units, international comparisons and as a platform for interventional studies.
authors.affiliation: Division of Child Health, St George's, University of London, Cranmer Terrace, London, UK. stev@doctors.org.uk
authors.forename: Stefania
authors.initials: S
authors.lastname: Vergnano
authors.forename: Esse
authors.initials: E
authors.lastname: Menson
authors.forename: Nigel
authors.initials: N
authors.lastname: Kennea
authors.forename: Nick
authors.initials: N
authors.lastname: Embleton
authors.forename: Alison Bedford
authors.initials: AB
authors.lastname: Russell
authors.forename: Timothy
authors.initials: T
authors.lastname: Watts
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Robinson
authors.forename: Andrew
authors.initials: A
authors.lastname: Collinson
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000382:microbiology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011159:Population Surveillance; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents