Reducing Antimicrobial USE and Nosocomial INfections in KIDS

A multinational collaborative consortium against pediatric HAIs and antibiotic use

with the aim of using data to design and implement sustainable interventions.

The reality

Hospital-acquired infections (HAIs) and the misuse and overuse of antimicrobials are well-recognized problems throughout Europe.

The reality in pediatrics

Pediatric surveillance data on HAIs in Europe is scarce and problematic, due in large part to differences in the definitions and surveillance techniques used both within and among countries. This renders aggregation and comparison of data difficult, and prevents benchmarking on either a national or a European level. Furthermore, those networks that do exist and produce high-quality data on HAIs in Europe, such as TESSy, focus largely on conditions encountered in adult patients.

Pediatric surveillance data on antibiotic use in Europe poses similar problems. Most efforts are directed at the local hospital or regional level, and antibiotic prescribing guidelines vary across Europe, even for clinical conditions where high-quality data is available. While a significant number of publications, such as ARPEC and GARPEC, have described variability in pediatric antibiotic use in Europe, there is still no structured and ongoing European approach to this problem and to the promotion of antimicrobial stewardship (ASP) in pediatric settings.

The Need

There is a critical need in Europe for

uniform data collection on HAIs and antibiotic use, as well as for

interventions to reduce HAIs and to promote the judicious use of antibiotics.


Reducing Antimicrobial and Nosocomial INfections in KIDS was born

as a multinational collaborative consortium to design and implement a unified European surveillance mechanism for pediatric HAIs and antibiotic use

with the aim of using data to design and implement sustainable interventions.


The long-term goal of RANIN-KIDS is to achieve optimal clinical outcomes among pediatric patients in Europe by fighting HAIs and reducing the non-judicious use of antibiotics.

Our first immediate goal was to create a multinational collaborative consortium that will design and implement a unified European surveillance mechanism for pediatric HAIs and antibiotic use. This surveillance will be conducted in pediatric hospitals or single units (e.g. general pediatric, NICU, PICU, pediatric oncology) using uniform methods and shared definitions. The consortium will constitute an adaptive network, expanding to include any collaborators who express interest and commitment, and allowing direct communication and the circulation of ideas among members.

Our second immediate goal is to use that data to design and implement sustainable interventions to prevent HAIs and promote ASP in pediatric settings throughout the countries in the consortium.

In January 2019, the efforts were supported and enhanced by collaborating with the European Society of Clinical Microbiology and Infectious Diseases Study Group for Antimicrobial Stewardship (ESGAP)

What We Have Achieved so Far

One of the first undertakings of the group was to describe the landscape of pediatric antimicrobial stewardship programs in Europe.

So far, RANIN-KIDS has established a surveillance mechanism for Hand Hygiene compliance in 9 different PICUs in 6 countries (Estonia, Germany, Italy, Greece, Spain, Switzerland) using WHO’s “5 moments of hand hygiene” methodology and developing self-training modules and unique data collection tools. The results have already been presented in European Society for Paediatric Infectious Diseases conference (Abstract O052 / #1277) (ESPID, 2020) and has been awarded the “2021 ESPID’s Research Networking Presentation Award”. Manuscript is to be submitted soon.

At the same time the RANIN-KIDS network has managed to generate important data on surgical prophylaxis in 10 units in 6 countries (Cyprus, Estonia, Greece, Italy, Portugal, Spain) that identified targets for improvement in antibiotic use in pediatric surgery that can be easily attainable. This too has been presented in European conference (O066 / #1452) (ESPID, 2020)

You can find the abstracts here.


Contact j.kopsidas [[at]]