Rojas-Solís MB, Meza-Ortíz F

Language: Spanish
References: 13
Page: 105-111
PDF size: 127.71 Kb.

ABSTRACT

Objective: To know the etiology, clinical manifestations and alterations of laboratory associated to neonatal sepsis at Neonatology Department of the Acapulco General Hospital.
Methods: Analytical observational study, report of cases. Analysis of the medical files of the patients with neonatal sepsis and isolated germs between January 1st to 1999 to December 31, 2000, studying 40 variables.
Results: We found 20 patients with sepsis and isolated germ, but medical file was recovered only in 12 of them, the presentation of sepsis was early in all the cases, the gram negative germs (Klebsiella and Serratia) were most common. The clinical picture was inespecific, agreeing with the medical literature. The male: female relation was of 1.4:1. The preterm, low weight, premature rupture of membranes, maternal fever and chorioamnionitis was not significantly associated with neonatal infection. Thrombocytopenia (75%), and neutropenia (66.7%)was the predominant alterations of the complete blood count and differential . Mortality was of 16.7%.
Conclusions: In the studied population the gram negative germs were the more frequently isolated. The clinical manifestations of neonatal sepsis were inespecific. Knowing the bacteriological profiles and antibiotic sensitivity for each hospital allows to establish empirical treatment protocols that guarantee a suitable cover of bacteria.

REFERENCES

1. Álvarez-Martín T, Montero-Alonso R, Barbadillo-Izquierdo F, Sastre-Huerta E, Alonso-Álvarez B. Sepsis neonatal 1986-1996 Rev Esp Pediatr 1997; 419-424.

2. Arredondo-García JL, Ortiz-Ibarra FJ, Solórzano-Santos F, Segura-Cervantes E, Beltrán-Zúñiga M. Etiología de la septicemia en una Unidad de Perinatología. Informe de siete años. Bol Hosp Infant Mex 1994; 51:317-323.

3. Zamora-Castorena S, Murguía-de-Sierra MT. Cinco años de experiencia con sepsis neonatal en un centro pediátrico. Rev Invest Clin 1998; 50:463-470.

4. Ahmed-Bhutta Z. Neonatal bacterial infections in developing countries: Strategies for prevention. Semin Neonatol 1999; 4:159-171.

5. López-Almaraz R, Hernández-González MJ, Doménech-Martínez E. Bacteriemias verticales: ¿Tratar o no tratar?. Anales Españoles de Pediatría 2001; 54: 160-164.

6. Casellas JM. Enfoque crítico del uso de ampicilina más cefotaxima como tratamiento empírico inicial para sepsis neonatal precoz. Rev Hosp Mat Inf Ramón Sardá 1997;16(3):127-132.

7. Philip AGS. Decreased use of antibiotics using a neonatal sepsis screening technique. J Pediatr 1981; 98:795-799.

8. Escobar G, De Kun L, Armstrong MA, Gardner M, Folck B, Verdi J, et al. Neonatal sepsis workups in infants <2000 grams at birth: A populationbased study. Pediatrics 2000; 106: 256-261.

9. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979; 95(1): 89-98.

10. Weinberg AG, Rosenfeld CR, Manroe BL, Browne R, Neonatal blood cell count in health and disease. II. Values for linphocytes, monocytes and eosinophils. J Pediatr 1979; 96(3): 462-466.

11. Garner AM, Hodgman JE. Can fullterm and nearterm infants at risk for sepsis be managed safely without antibiotics?. J Perinatology 1999; 19(8) Part 1: 589-592.

12. Gaitan-Meza JJ, Mancilla-Ramírez J, Arredondo-García JL, Alcalá- Padilla I, Ramírez-Valdivia JM, Antro-Redón J, et al. Etiología de sepsis neonatal y sensibilidad a los antibióticos en el Nuevo Hospital Civil de Guadalajara. Enf Infecc Microbiol Clin 1996; 16: 80-85.

13. Saénz-Llorens X. Sepsis y Choque Séptico. En: Saldaña N, editor. Infectología Pediátrica. México: Trillas; 1996. p.p. 419-421.