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2019, Number 3

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Rev Hosp Jua Mex 2019; 86 (3)

Epidemiology of neonatal early and late onset sepsis at Neonatal Intensive Care Unit

Ulloa-Ricárdez A, Salazar-Espino B

Language: Spanish
References: 23
Page: 110-115
PDF size: 140.70 Kb.


ABSTRACT

Introduction: Neonatal sepsis is an important cause of mortality and morbidity. Knowing the etiology and risk factors of neonatal sepsis and the bacterial profile patterns of the cultures obtained in the neonatal intensive care unit and the microbiological characteristics allow to establish control measures. Objective: to describe the events of early and late neonatal sepsis in a neonatal intensive care unit, the most frequent causal agents and their relationship with the degree of maturity and weight of the newborns. Material and methods: Data from the clinical record of newborns who presented sepsis event in the neonatal intensive care unit with positive cultures from February 2010 to January 2014, categorized as early neonatal sepsis (less than 72 hours of life at the onset of signs and symptoms) or late onset (greater than 72 hours) were analyzed. Results: A total of 122 neonatal sepsis events with positive cultures were recorded with 950 admissions (12.8%). 64 were early neonatal sepsis and 58 were late neonatal sepsis. Premature infants were 89% and 52% of the female sex. The average weight was 1,850 grams and the average gestational age was 32.5 weeks. 10 (8%) were born with extremely low birth weight. 28 (23%) very low birth weight and 67 (54.9%) low birth weight. The average number of days of stay was 22 days (interval 10-93). The average stay of central venous catheter was 16 days. Staphylococcus coagulasa-negative was the most frequent isolated microorganism in late neonatal sepsis and E. coli and Klebsiella pneumoniae were the most frequent in early neonatal sepsis. Conclusions: In this group of patients, events of early neonatal sepsis, prematurity and low birth weight were more frequent, Escherichia coli and Klebsiella pneumoniae were the most frequent microorganisms in early neonatal sepsis. and Staphilococcus epidermidis and Staphilococcus aureus in late neonatal sepsis. It is important to constantly review the adherence to infection prevention measures in Neonatal Intensive Care Units in order to decrease the frequency of infections, such as adequate management of catheters, adequate management of intravenous therapy, and rational use of antibiotics to avoid multiple resistances.


REFERENCES

  1. Gowda H, Norton R, White A, Kandasamy Y. Late-onset neonatal sepsis a 10-year review from North Queensland, Australia. Pediatr Infect Dis Dis J. 2017; 36(9): 883-8.

  2. Schrag SJ, Farley MM, Petit S, Reingold A, Weston EJ, Pondo T, et al. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014. Pediatrics. 2016; 138(6): pii: e20162013.

  3. Anderson JG, Baer RJ, Partridge JC, Kuppermann M, Franck LS, Rand L, et al. Survival and major morbidity of extremely preterm infants: a population-based study. Pediatrics. 2016; 138(1): pii: e20154434.

  4. Wynn JL, Wong HR, Shanley TP, Bizzarro MJ, Saiman L, Polin RA. Time for a neonatal-specific consensus definition for sepsis. Pediatr Crit Care Med. 2014; 15: 523-28.

  5. Verma P, Berwal PK, Nagaraj N, Swami S, Jivaji P, Narayan S. Neonatal sepsis: epidemiology, clinical spectrum, recent antimicrobial agents and their antibiotic susceptibility pattern. Int J Contemp Pediatrics. 2017; 2: 176-80.

  6. Tijerina-Torres CY, Rodríguez-Balderrama I, Gallegos-Dávila JA, Cavazos-Elizondo M, Romero-Rocha JA. Sepsis neonatal intrahospitalaria. Incidencia y factores de riesgo. Rev Med Inst Mex Seguro Soc. 2011; 49(6): 643-8.

  7. Useche J, Nuñez E, Torres H. Agentes implicados en infección neonatal nosocomial y patrones de sensibilidad antimicrobiana. Rev Fac Ciencias de la Salud. 2012; 16(3): 33-9.

  8. Hoyos A, Suárez M, Massaro M, Ortig G, Aguirre J, Uribe A. Infección del torrente circulatorio en una Unidad de Neonatología de Medellín-Colombia, 2008-2009. Rev Chil Infect. 2010; 27(6): 491-8.

  9. Bizzarro MJ, Shabanova V, Baltimore RS, Dembry LM, Ehrenkranz RA, Gallagher PG. Neonatal Sepsis 2004-2013: the rise and fall of coagulase-negative staphylococci. J Pediatr. 2015; 166(5): 1193-9.

  10. Schrag SJ, Farley MM, Petit S et al. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014. Pediatrics. 2016; 138(6): e20162013.

  11. Braye K, Foureur M, de Waal K, Jones M, Putt E, Ferguson J. Epidemiology of neonatal early-onset sepsis in a geographically diverse Australian health district 2006-2016. PLoS One. 2019; 14(4): e0214298.

  12. Singh N, Dhayade A, Mohamed AL, Chaudhari TV. Postnatal morbidity and mortality in preterm infants following antacid use: a retrospective audit. Int J Pediatr. 2016; 2016; 9649162.

  13. Pryhuber GS. Postnatal infections and immunology affecting chronic lung disease of prematurity. Clin Perinatol. 2015; 42(4): 697-718.

  14. Saleem B, Naveen S, Michael P. Immune reponses in neonates. Expert Rev Clin Immunol. 2014; 10(9): 11171-84.

  15. Secretaría de Salud. Norma Oficial Mexicana NOM-045-SSA2-2005, para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales. Diario Oficial de la Federación del 20 de Noviembre de 2009.

  16. Cantey JB, Milstone MA. Bloodstream infections epidemiology and resistance. Clin Perinatol 2015; 42: 1-16.

  17. Ohlsson A, Lacy JB. Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants. Cochrane Database Syst Rev. 2013; 7(07): CD000361.

  18. Borghesi A, Stronati M, Castagnoli R, Ioimo I, Achille C, Manzoni P, et al. Novel approaches to the study of neonatal infections. Am J Perinatol. 2018; 35: 570-4.

  19. Schuller SS, Kramer BW, Villamor E, Spittler A, Berger AA, Levy O. Immunomodulation to prevent or treat neonatal sepsis: past, present, and future. Front Pediatr. 2018; 6: 199.

  20. Srinivasan L, Swarr DT, Sharma M, Cotten CM, Kirpalani H. Systematic review and meta-analysis: gene association studies in neonatal sepsis. Am J Perinatol. 2017; 34(07): 684-92.

  21. Israel I, Wang Y, Bulek K, et al. Human Adaptive immunity rescues an inborn error of innate immunity. Cell 2017; 168(05): 789-800.

  22. Kelly MS, Benjamin DK, P. Smith PB. The epidemiology and diagnosis of invasive candidiasis among premature infants. Clin Perinatol. 2015; 42(1): 105-17.

  23. Pokhrel B, Koirala T, Shah G, Joshi S, Baral P. Bacteriological profile and antibiotic susceptibility of neonatal sepsis in Neonatal Intensive Care Unit of a tertiary hospital in Nepal. BMC Pediatr. 2018; 18: 208.




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