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Author Paul T Heath

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An optimised dosing regimen versus a standard dosing regimen of vancomycin for the treatment of late onset sepsis due to Gram-positive microorganisms in neonates and infants aged less than 90 days (NeoVanc): study protocol for a randomised controlled trial.

Louise F Hill, Mark A Turner, Irja Lutsar, Paul T Heath, Pollyanna Hardy, Louise Linsell, Evelyne Jacqz-Aigrain, Emmanuel Roilides, Mike Sharland, ,

BACKGROUND:Vancomycin has been used in clinical practice for over 50 years; however, validated, pharmacokinetic (PK) data relating clinical outcomes to different dosing regimens in neonates are lacking. Coagulase negative staphylococci (CoNS) are the most commonly isolated organisms in neonatal, late-onset sepsis (LOS). Optimised use to maximise efficacy while minimising toxicity ... Read more >>

Trials (Trials)
[2020, 21(1):329]

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Meropenem vs standard of care for treatment of neonatal late onset sepsis (NeoMero1): A randomised controlled trial.

Irja Lutsar, Corine Chazallon, Ursula Trafojer, Vincent Meiffredy de Cabre, Cinzia Auriti, Chiara Bertaina, Francesca Ippolita Calo Carducci, Fuat Emre Canpolat, Susanna Esposito, Isabelle Fournier, Maarja Hallik, Paul T Heath, Mari-Liis Ilmoja, Elias Iosifidis, Jelena Kuznetsova, Laurence Meyer, Tuuli Metsvaht, George Mitsiakos, Zoi Dorothea Pana, Fabio Mosca, Lorenza Pugni, Emmanuel Roilides, Paolo Rossi, Kosmas Sarafidis, Laura Sanchez, Michael Sharland, Vytautas Usonis, Adilia Warris, Jean-Pierre Aboulker, Carlo Giaquinto, ,

BACKGROUND:The early use of broad-spectrum antibiotics remains the cornerstone for the treatment of neonatal late onset sepsis (LOS). However, which antibiotics should be used is still debatable, as relevant studies were conducted more than 20 years ago, recruited in single centres or countries, evaluated antibiotics not in clinical use anymore ... Read more >>

PLoS ONE (PloS one)
[2020, 15(3):e0229380]

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Evaluation of the Coverage of 3 Antibiotic Regimens for Neonatal Sepsis in the Hospital Setting Across Asian Countries.

Julia A Bielicki, Mike Sharland, Paul T Heath, A Sarah Walker, Ramesh Agarwal, Paul Turner, David A Cromwell,

Importance:High levels of antimicrobial resistance in neonatal bloodstream isolates are being reported globally, including in Asia. Local hospital antibiogram data may include too few isolates to meaningfully examine the expected coverage of antibiotic regimens. Objective:To assess the coverage offered by 3 antibiotic regimens for empirical treatment of neonatal sepsis in ... Read more >>

JAMA Netw Open (JAMA network open)
[2020, 3(2):e1921124]

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PCR for the detection of pathogens in neonatal early onset sepsis.

Clarissa Oeser, Marcus Pond, Philip Butcher, Alison Bedford Russell, Philipp Henneke, Ken Laing, Timothy Planche, Paul T Heath, Kathryn Harris,

BACKGROUND:A large proportion of neonates are treated for presumed bacterial sepsis with broad spectrum antibiotics even though their blood cultures subsequently show no growth. This study aimed to investigate PCR-based methods to identify pathogens not detected by conventional culture. METHODS:Whole blood samples of 208 neonates with suspected early onset sepsis ... Read more >>

PLoS ONE (PloS one)
[2020, 15(1):e0226817]

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Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China.

Yijun Ding, Yajuan Wang, Yingfen Hsia, Mike Sharland, Paul T Heath,

BACKGROUND:Carbapenems are β-lactam antibiotics which are used to treat severe infections caused by multidrug resistant Enterobacteriacea. The recent emergence and rapid spread of Enterobacteriaceae resistant to carbapenems is a global concern. We undertook a systematic review of the antibiotic susceptibility and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in Chinese neonates. METHODS:Systematic ... Read more >>

Ann. Clin. Microbiol. Antimicrob. (Annals of clinical microbiology and antimicrobials)
[2019, 18(1):36]

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Global Divergence From World Health Organization Treatment Guidelines for Neonatal and Pediatric Sepsis.

Charlotte Jackson, Yingfen Hsia, Romain Basmaci, Julia Bielicki, Paul T Heath, Ann Versporten, Herman Goossens, Mike Sharland,

We used data from 2 global point prevalence surveys of antibiotic prescribing to describe the treatment of sepsis in hospitalized neonates and children. One hundred eighty-five of 824 neonates (22.5%) and 9/786 children (1.1%) received a World Health Organization-recommended first-line treatment; of the remainder, 9/639 neonates (1.4%) and 102/777 children ... Read more >>

Pediatr. Infect. Dis. J. (The Pediatric infectious disease journal)
[2019, 38(11):1104-1106]

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Neonatal seizures: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data.

Serena Pellegrin, Flor M Munoz, Michael Padula, Paul T Heath, Lee Meller, Karina Top, Jo Wilmshurst, Max Wiznitzer, Manoja Kumar Das, Cecil D Hahn, Merita Kucuku, James Oleske, Kollencheri Puthenveettil Vinayan, Elissa Yozawitz, Satinder Aneja, Niranjan Bhat, Geraldine Boylan, Sanie Sesay, Anju Shrestha, Janet S Soul, Beckie Tagbo, Jyoti Joshi, Aung Soe, Helena C Maltezou, Jane Gidudu, Sonali Kochhar, Ronit M Pressler, ,

Vaccine (Vaccine)
[2019, 37(52):7596-7609]

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Hospital clusters of invasive Group B Streptococcal disease: A systematic review.

Simon M Collin, Peter Lamb, Elita Jauneikaite, Kirsty Le Doare, Roberta Creti, Alberto Berardi, Paul T Heath, Shiranee Sriskandan, Theresa Lamagni,

OBJECTIVES:To characterize outbreaks of invasive Group B Streptococcal (iGBS) disease in hospitals. METHODS:Systematic review using electronic databases to identify studies describing iGBS outbreaks/clusters or cross-infection/acquisition in healthcare settings where 'cluster' was defined as ≥2 linked cases. PROSPERO CRD42018096297. RESULTS:Twenty-five references were included describing 30 hospital clusters (26 neonatal, 4 adult) ... Read more >>

J. Infect. (The Journal of infection)
[2019, 79(6):521-527]

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Understanding pregnant women's readiness to engage in risk-reducing measures to prevent infections during pregnancy.

Tushna Vandrevala, Victoria Barber, Anna Calvert, Caroline Star, Asma Khalil, Paul Griffiths, Paul T Heath, Christine E Jones,

The aim of this study was to develop a conceptual understanding of women's readiness to engage in behaviours to reduce the risk of acquiring infections during pregnancy, using cytomegalovirus, the most common congenital infection as a case. Thirty-three pregnant women participated in semi-structured interviews. The findings illustrate that for behavioural ... Read more >>

J Health Psychol (Journal of health psychology)
[2019, :1359105319884609]

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Attitudes of Pregnant Women and Healthcare Professionals Toward Clinical Trials and Routine Implementation of Antenatal Vaccination Against Respiratory Syncytial Virus: A Multicenter Questionnaire Study.

Christopher R Wilcox, Anna Calvert, Jane Metz, Eliz Kilich, Rachael MacLeod, Kirsten Beadon, Paul T Heath, Asma Khalil, Adam Finn, Matthew D Snape, Tushna Vandrevala, Tom Nadarzynski, Matthew A Coleman, Christine E Jones,

INTRODUCTION:Respiratory syncytial virus (RSV) is a common cause of infant hospitalization and mortality. With multiple vaccines in development, we aimed to determine: (1) the awareness of RSV among pregnant women and healthcare professionals (HCPs), and (2) attitudes toward clinical trials and routine implementation of antenatal RSV vaccination. METHODS:Separate questionnaires for ... Read more >>

Pediatr. Infect. Dis. J. (The Pediatric infectious disease journal)
[2019, 38(9):944-951]

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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, Cristiane Teixeira, Paul Turner, Ladin Nhan, Jaime Orrego, Paola Marsela Pérez, Lifeng Qi, Vassiliki Papaevangelou, Pinelope Triantafyllidou, Elias Iosifidis, Emmanuel Roilides, Kosmas Sarafidis, Dasaratha Ramaiah Jinka, Raghuprakash Reddy Nayakanti, Praveen Kumar, Vikas Gautam, Vinayagam Prakash, Arasar Seeralar, Srinivas Murki, Hemasree Kandraju, Sanjeev Singh, Anil Kumar, Leslie Lewis, Jayashree Pukayastha, Sushma Nangia, Yogesha K N, Suman Chaurasia, Harish Chellani, Stephen Obaro, Angela Dramowski, Adrie Bekker, Andrew Whitelaw, Reenu Thomas, Sithembiso Christopher Velaphi, Daynia Elizabeth Ballot, Trusha Nana, Gary Reubenson, Joy Fredericks, Suvaporn Anugulruengkitt, Anongnart Sirisub, Pimol Wong, Sorasak Lochindarat, Suppawat Boonkasidecha, Kanchana Preedisripipat, Tim R Cressey, Pongsatorn Paopongsawan, Pagakrong Lumbiganon, Dounghatai Pongpanut, Pra-Ornsuda Sukrakanchana, Philippa Musoke, Linus Olson, Mattias Larsson, Paul T Heath, Michael Sharland,

OBJECTIVE:To 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). DESIGN:A web-based survey using a REDCap database was circulated ... Read more >>

Arch. Dis. Child. (Archives of disease in childhood)
[2020, 105(1):26-31]

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Strategic Trials to Define the Best Available Treatment for Neonatal and Pediatric Sepsis Caused by Carbapenem-resistant Organisms.

Daniele Donà, Mike Sharland, Paul T Heath, Laura Folgori,

The optimal standard of care for carbapenem-resistant bloodstream infections in children is currently unknown. This systematic review, aiming to define the best available treatments to be compared with new antibiotics in clinical trials, clearly points out the paucity of available data. The simplification and a wider harmonization of study design ... Read more >>

Pediatr. Infect. Dis. J. (The Pediatric infectious disease journal)
[2019, 38(8):825-827]

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Uncertainties in Screening and Prevention of Group B Streptococcus Disease.

Kirsty Le Doare, Paul T Heath, Jane Plumb, Natalie A Owen, Peter Brocklehurst, Lucy C Chappell,

In autumn 2016, the UK Department of Health (now Department of Health and Social Care) convened 2 meetings to discuss how to address research evidence gaps in order to minimize the impact of infant group B streptococcus (GBS) disease in the United Kingdom. At that meeting, a number of research ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2019, 69(4):720-725]

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Invasive Pneumococcal Disease in UK Children <1 Year of Age in the Post-13-Valent Pneumococcal Conjugate Vaccine Era: What Are the Risks Now?

Alison Kent, Ashley Makwana, Carmen L Sheppard, Sarah Collins, Norman K Fry, Paul T Heath, Mary Ramsay, Shamez N Ladhani,

BACKGROUND:Invasive pneumococcal disease (IPD) has declined significantly since the introduction of pneumococcal conjugate vaccines (PCVs). It is not known whether certain infant populations remain at higher risk of IPD in countries with established 13-valent PCV (PCV13) programs. We aimed to describe the epidemiology, clinical characteristics, serotype distribution, and outcomes of ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2019, 69(1):84-90]

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Determinants of Influenza and Pertussis Vaccination Uptake in Pregnancy: A Multicenter Questionnaire Study of Pregnant Women and Healthcare Professionals.

Christopher R Wilcox, Anna Calvert, Jane Metz, Eliz Kilich, Rachael MacLeod, Kirsten Beadon, Paul T Heath, Asma Khalil, Adam Finn, Matthew D Snape, Tushna Vandrevala, Tom Nadarzynski, Matthew A Coleman, Christine E Jones,

INTRODUCTION:Uptake rates of antenatal vaccination remain suboptimal. Our aims were to determine (1) the acceptability of routine vaccination among pregnant women, (2) the confidence of maternity healthcare professionals (HCPs) discussing vaccination and (3) HCP opinion regarding the optimum healthcare site for vaccine administration. METHODS:Separate questionnaires for pregnant women and HCPs ... Read more >>

Pediatr. Infect. Dis. J. (The Pediatric infectious disease journal)
[2019, 38(6):625-630]

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Group B Streptococcus: Trials and Tribulations.

Hannah G Davies, Clara Carreras-Abad, Kirsty Le Doare, Paul T Heath,

Group B Streptococcus (GBS) is estimated to have caused 319,000 cases of neonatal disease resulting in 90,000 infant deaths globally in 2015. It is also associated with maternal sepsis, preterm births, stillbirths and neonatal encephalopathy. There is a significant burden of neurologic impairment among survivors of infant GBS disease. Intrapartum ... Read more >>

Pediatr. Infect. Dis. J. (The Pediatric infectious disease journal)
[2019, 38(6S Suppl 1):S72-S76]

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The role of immune correlates of protection on the pathway to licensure, policy decision and use of group B Streptococcus vaccines for maternal immunization: considerations from World Health Organization consultations.

Johan Vekemans, Jonathan Crofts, Carol J Baker, David Goldblatt, Paul T Heath, Shabir A Madhi, Kirsty Le Doare, Nick Andrews, Andrew J Pollard, Samir K Saha, Stephanie J Schrag, Peter G Smith, David C Kaslow,

The development of a group B Streptococcus (GBS) vaccine for maternal immunization constitutes a global public health priority, to prevent GBS-associated early life invasive disease, stillbirth, premature birth, maternal sepsis, adverse neurodevelopmental consequences, and to reduce perinatal antibiotic use. Sample size requirements for the conduct of a randomized placebo-controlled trial ... Read more >>

Vaccine (Vaccine)
[2019, 37(24):3190-3198]

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Safety and efficacy of 2% chlorhexidine gluconate aqueous versus 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to percutaneous central venous catheter insertion in preterm neonates: the ARCTIC randomised-controlled feasibility trial protocol.

Paul Clarke, Jean V Craig, John Wain, Catherine Tremlett, Louise Linsell, Ursula Bowler, Ed Juszczak, Paul T Heath,

INTRODUCTION:Catheter-related sepsis is one of the most dangerous complications of neonatal intensive care and is associated with significant morbidity and mortality. Use of catheter-care 'bundles' has reduced the incidence of catheter-related sepsis, although individual components have not been well studied. Better evidence is needed to guide selection of the most ... Read more >>

BMJ Open (BMJ open)
[2019, 9(2):e028022]

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Serocorrelates of protection against infant group B streptococcus disease.

Kirsty Le Doare, Beate Kampmann, Johan Vekemans, Paul T Heath, David Goldblatt, Moon H Nahm, Carol Baker, Morven S Edwards, Gaurav Kwatra, Nick Andrews, Shabir A Madhi, Ajoke Sobanjo Ter Meulen, Annaliesa S Anderson, Bart Corsaro, Per Fischer, Andrew Gorringe,

Group B streptococcus (GBS) is a leading cause of young infant mortality and morbidity globally, with vaccines being developed for over four decades but none licensed to date. A serocorrelate of protection against invasive disease in young infants is being considered to facilitate vaccine early licensure, followed by demonstration of ... Read more >>

Lancet Infect Dis (The Lancet. Infectious diseases)
[2019, 19(5):e162-e171]

Cited: 2 times

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Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial.

,

BACKGROUND:Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications. The aim of this large randomised ... Read more >>

Lancet (Lancet (London, England))
[2019, 393(10170):423-433]

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Group B streptococcal disease in UK and Irish infants younger than 90 days, 2014-15: a prospective surveillance study.

Catherine P O'Sullivan, Theresa Lamagni, Darshana Patel, Androulla Efstratiou, Robert Cunney, Mary Meehan, Shamez Ladhani, Arlene J Reynolds, Ruth Campbell, Lorraine Doherty, Margaret Boyle, Georgia Kapatai, Victoria Chalker, Diane Lindsay, Andrew Smith, Eleri Davies, Christine E Jones, Paul T Heath,

BACKGROUND:Group B streptococcus is a leading cause of serious infection in young infants in many countries worldwide. We aimed to define the burden and clinical features of invasive group B streptococcal disease in infants younger than 90 days in the UK and Ireland, together with the characteristics of disease-causing isolates. ... Read more >>

Lancet Infect Dis (The Lancet. Infectious diseases)
[2019, 19(1):83-90]

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Epidemiology and healthcare factors associated with neonatal enterococcal infections.

Joanna Wang, Christina Kortsalioudaki, Paul T Heath, Jim Buttery, Paul Clarke, Despoina Gkentzi, Mark Anthony, Kenneth Tan, ,

OBJECTIVE:To investigate the epidemiology and healthcare factors associated with late-onset neonatal enterococcal infections. DESIGN:Multicentre, multinational retrospective cohort study using prospectively collected infection data from a neonatal infection surveillance network between 2004 and 2016; this was supplemented with healthcare data from a questionnaire distributed to participating neonatal units. SETTING:Sixty neonatal units ... Read more >>

Arch. Dis. Child. Fetal Neonatal Ed. (Archives of disease in childhood. Fetal and neonatal edition)
[2019, 104(5):F480-F485]

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Enteral lactoferrin to prevent infection for very preterm infants: the ELFIN RCT.

James Griffiths, Paula Jenkins, Monika Vargova, Ursula Bowler, Edmund Juszczak, Andrew King, Louise Linsell, David Murray, Christopher Partlett, Mehali Patel, Janet Berrington, Nicholas Embleton, Jon Dorling, Paul T Heath, William McGuire, Sam Oddie,

BACKGROUND:Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications. OBJECTIVE:To determine whether or not enteral ... Read more >>

Health Technol Assess (Health technology assessment (Winchester, England))
[2018, 22(74):1-60]

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Cost-effectiveness analysis of maternal immunisation against group B Streptococcus (GBS) disease: A modelling study.

Kyriaki Giorgakoudi, Catherine O'Sullivan, Paul T Heath, Shamez Ladhani, Theresa Lamagni, Mary Ramsay, Hareth Al-Janabi, Caroline Trotter,

BACKGROUND:There is a considerable global burden of invasive group B streptococcal (GBS) disease. Vaccines are being developed for use in pregnant women to offer protection to neonates. OBJECTIVE:To estimate the potential impact and cost-effectiveness of maternal immunisation against neonatal and maternal invasive GBS disease in the UK. METHODS:We developed a ... Read more >>

Vaccine (Vaccine)
[2018, 36(46):7033-7042]

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The Fourth International Neonatal and Maternal Immunization Symposium (INMIS 2017): Toward Integrating Maternal and Infant Immunization Programs.

Flor M Munoz, Pierre Van Damme, Ener Dinleyici, Ed Clarke, Beate Kampmann, Paul T Heath, Ofer Levy, Elke Leuridan, Clare Cutland, Ajoke Sobanjo-Ter Meulen, Arnaud Marchant,

Prevention of serious infections in pregnant mothers, newborns, and young infants through immunization during pregnancy and in early life has the potential to further reduce maternal and neonatal morbidity and mortality worldwide. In the past decade, research in this field has advanced substantially, from the understanding of the biology and ... Read more >>

mSphere (mSphere)
[2018, 3(6):]

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