Neonatal infections in England: the NeonIN surveillance network.
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.
Vergnano
Stefania
S
Division of Child Health, St George's, University of London, Cranmer Terrace, London, UK. stev@doctors.org.uk
Menson
Esse
E
Kennea
Nigel
N
Embleton
Nick
N
Russell
Alison Bedford
AB
Watts
Timothy
T
Robinson
Michael J
MJ
Collinson
Andrew
A
Heath
Paul T
PT
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
D000900:Anti-Bacterial Agents