Early sepsis in premature infants in Neonatal Intensive Care Units

• Autor(a) principal: Cristina Gomes Lima, Raquel
• Data de Publicação: 2024
• Outros Autores: Souto de Medeiros, Danielle, Cheles Vieira, Verônica, Silvana de Oliveira e Silva, Carla
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista de Epidemiologia e Controle de Infecção
• Texto Completo: https://online.unisc.br/seer/index.php/epidemiologia/article/view/18920
• topic: Recém-Nascido Prematuro; Sepse Neonatal Precoce; UTI neonatal; Estudos Longitudinais; Recién Nacido Prematuro; Sepsis Neonatal Temprana; UCI neonatal; Estudios longitudinales.; Infant Premature; Early-Onset Sepsis; Neonatal Intensive Care Units; Longitudinal Studies.

Justification and Objectives: despite great advances in neonatal care, deaths in this age period remain high throughout the world, highlighting prematurity and neonatal sepsis as the main causes. This study aimed to assess the incidence of early neonatal sepsis and associated maternal and neonatal risk factors in premature infants admitted to Neonatal Intensive Care Units in a city in the countryside of Bahia. Methods: a non-concurrent cohort study including 268 preterm infants admitted on the day of birth between January 2016 and December 2017 and followed during the neonatal period. The incidence of early neonatal sepsis and its risk factors were calculated. Poisson regression with robust variance was used for multivariate analysis, obtaining estimates of Relative Risk (RR) and respective 95% Confidence Intervals (CI). Statistical significance was considered when p-value ≤ 0.05. Results: incidence of early sepsis was 38% (102), of which 12.3% (33) had sepsis treated by the clinic and 25.7% (69) also presented at least one laboratory alteration. The diagnosis of presumed early sepsis was identified in 63.4% (170); no sepsis was confirmed with culture; and sepsis was ruled out in 25.5% (68) of premature infants. The following were positively associated with the outcome: being born by vaginal delivery (RR: 1.53; 95%CI: 1.19-1.97), gestational age less than 32 weeks (RR: 1.86; 95%CI: 1.35-2.57), less than 28 weeks (RR: 2.16; 95%CI: 1.59-2.94) and 5-minute Apgar score less than 7 (RR: 1.45; 95%CI: 1.14-1.83). Conclusion:there was a high incidence of early sepsis compared with international and national research. The results suggest the need for strategies to prevent prematurity and improve care during childbirth.