Risk factors associated with late-onset neonatal sepsis
Keywords:
Pregnancy Complications, Infectious, Neonatal Sepsis, Risk FactorsAbstract
Background: Sepsis is one of the main causes of morbidity and mortality in neonates.
Objective: To identify the risk factors for neonatal sepsis in a neonatal unit from March to October, 2016.
Methods: Case-control study. The factors analyzed were: a) neonatal factors such as: type of delivery, sex, birth weight, gestational age, criteria for systemic inflammatory response syndrome, type of sepsis (early or late) and blood culture result; B) invasive methods such as: central catheterization, total parenteral nutrition, umbilical catheterization and mechanical ventilation; C) maternal factors such as: number of prenatal controls, infection during pregnancy, premature rupture of membranes, maternal age and maternal fever. Odds Ratio was used to determine association.
Results: For the development of early-onset sepsis, significant risk factors were: thermodynamic imbalance, tachycardia and maternal fever. With regard to late-onset sepsis, significant associations were found for thermodynamic imbalance, umbilical catheterization, mechanical ventilation and insufficient prenatal care.
Conclusions: Thermodynamic imbalance, tachycardia, mechanical ventilation, umbilical catheterization, maternal fever, and insufficient prenatal care were the probable risk factors associated with neonatal sepsis.
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Organzación Mundial de la Salud - UNICEF. Visitas domiciliarias al recién nacido: una estrategia para aumentar la supervivencia. Ginebra, Suiza: OMS; 2012. Disponible en: http://apps.who.int/iris/bitstream/10665/70057/1/WHO_FCH_CAH_09.02_spa.pdf
Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: Children are not small adults! Open Inflamm J. 2011;4(513):4-15. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3665507&tool=pmcentrez&rendertype=abstract
Fernández-Colomer B. Sepsis del recién nacido y del primer semestre de la vida. Rev Chil pediatría. 2008;17(4):189-206. Disponible en: http://www.aeped.es/sites/default/files/documentos/21_0.pdf
Lawn JE, Osrin D, Adler A, Cousens S. Four million neonatal deaths: Counting and attribution of cause of death. Paediatr Perinat Epidemiol. 2008;22(5):410-6.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, De Bernis L. Evidence-based, cost-effective interventions: How many newborn babies can we save? Lancet. 2005;365(9463):977-88.
Countdown Coverage Writing Group, Countdown to 2015 Core Group, Bryce J, Daelmans B, Dwivedi A, Fauveau V, et al. Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet. 2008;371(9620):1247-58.
Shah BA, Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence. 2014;5(1):170-8. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3916371&tool=pmcentrez&rendertype=abstract
Melville JM, Moss TJM. The immune consequences of preterm birth. Front Neurosci. 2013;7(7):1-9.
Kung YH, Hsieh YF, Weng YH, Lien RI, Luo J, Wang Y, et al. Risk factors of late-onset neonatal sepsis in Taiwan: A matched case-control study. J Microbiol Immunol Infect. 2013;49(3):430-5. Disponible en: http://dx.doi.org/10.1016/j.jmii.2013.10.001
Hornik CP, Fort P, Clark RH, Watt K, Benjamin DK Jr, Smith PB, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev. 2013;88(Suppl 2):S69-72.
Chiesa C, Panero A, Osborn JF, Simonetti AF, Pacifico L. Diagnosis of Neonatal Sepsis: A Clinical and Laboratory Challenge. Clin Chem. 2004;50(2):279-87.
Wiens MO, Kumbakumba E, Kissoon N, Ansermino JM, Ndamira A, Larson CP. Pediatric sepsis in the developing world: Challenges in defining sepsis and issues in post-discharge mortality. Clin Epidemiol. 2012;4(1):319-25.
Vergnano S. Neonatal sepsis: an international perspective. Arch Dis Child - Fetal Neonatal Ed. 2005;90(3):F220-f224. Disponible en: http://fn.bmj.com/cgi/doi/10.1136/adc.2002.022863
Ruiz D del RV. Prevalencia de sepsis neonatal y factores asociados en el servicio de neonatología, hospital Vicente Corral Moscoso en Cuenca - Ecuador. El Escorial. 2012;34,56.
Hofer N, Müller W, Resch B. Neonates presenting with temperature symptoms: Role in the diagnosis of early onset sepsis. Pediatr Int. 2012;54(4):486-90.
Ahmad MS, Ali N, Mehboob N, Mehmood R, Ahmad M, Wahid A. Temperature on admission among cases of neonatal sepsis and its association with mortality. J Pak Med Assoc. 2016;66(10):1303-6.
Cohen-Wolkowiez M, Moran C, Benjamin DK, Cotten CM, Clark RH, Smith PB. Early and late onset sepsis in late preterm infants. Pediatr Infect Dis J. 2009;28(12):1052-6. Disponible en: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2798577&tool=pmcentrez&rendertype=abstract
Rojas MA, Efird MM, Lozano JM, Bose CL, Rojas MX, Rondón MA, et al. Risk factors for nosocomial infections in selected neonatal intensive care units in Colombia, South America. J Perinatol. 2005;25(8):537-41.
Leal YA, Álvarez-Nemegyei J, Velázquez JR, Rosado-Quiab U, Diego-Rodríguez N, Paz-Baeza E, et al. Risk factors and prognosis for neonatal sepsis in southeastern Mexico: analysis of a four-year historic cohort follow-up. BMC Pregnancy Childbirth. 2012;12(1):48. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22691696
Yumani DFJ, van den Dungen FA, van Weissenbruch MM. Incidence and risk factors for catheter-associated bloodstream infections in neonatal intensive care. Acta Paediatr. 2013;102(7):e293-8. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23627968
Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2 Pt 1):285-91.
Partridge S, Balayla J, Holcroft CA, Abenhaim HA. Inadequate Prenatal Care Utilization and Risks of Infant Mortality and Poor Birth Outcome: A Retrospective Analysis of 28, 729, 765 U. S. Deliveries over 8 Years. Am J Perinatol. 2012;29(10):787-794.
Chan GJ, Lee AC, Baqui AH, Tan J, Black RE. Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-Analysis. PLoS Med. 2013;10
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