Freitas Felipe Teixeira de Mello, Romero Gustavo Adolfo Sierra
Secretaria de Estado de Saúde do Distrito Federal, Hospital Materno Infantil de Brasília, Brasília, DF, Brazil; Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brazil.
Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brazil.
Braz J Infect Dis. 2017 Jan-Feb;21(1):92-97. doi: 10.1016/j.bjid.2016.09.013. Epub 2016 Nov 19.
To describe early-onset neonatal sepsis (EOS) epidemiology in a public maternity hospital in Brasilia, Brazil.
We defined EOS as a positive blood culture result obtained from infants aged ≤72 hours of life plus treatment with antibiotic therapy for ≥5 days. Incidence was calculated based on the number of cases and total live births (LB). This is a descriptive study comparing the period of 2012-2013 with the period of 2014-September 2015, before and after implementation of antibiotic prophylaxis during labor for group B streptococcus (GBS) prevention, respectively.
Overall, 36 infants developed EOS among 21,219 LB (1.7 cases per 1000 LB) and 16 died (case fatality rate of 44%). From 2014, 305 vaginal-rectal swabs were collected from high-risk women and 74 (24%) turned out positive for GBS. After implementation of GBS prevention guidelines, no new cases of GBS were detected, and the EOS incidence was reduced from 1.9 (95% CI 1.3-2.8) to 1.3 (95% CI 0.7-2.3) cases per 1000 LB from 2012-2013 to 2014-September 2015 (p=0.32).
Although the reduction of EOS incidence was not significant, GBS colonization among pregnant women was high, no cases of neonatal GBS have occurred after implementation of prevention guidelines.
描述巴西巴西利亚一家公立妇产医院早发型新生儿败血症（EOS）的流行病学情况。
我们将EOS定义为出生≤72小时的婴儿血培养结果呈阳性，外加接受≥5天的抗生素治疗。发病率根据病例数和总活产数（LB）计算。这是一项描述性研究，分别比较了2012 - 2013年期间与2014年 - 2015年9月期间，即分娩期间预防B族链球菌（GBS）的抗生素预防措施实施前后的情况。
总体而言，在21219例活产婴儿中有36例发生EOS（每1000例活产中有1.7例），16例死亡（病死率为44%）。从2014年起，从高危女性中采集了305份阴道 - 直肠拭子，74份（24%）GBS检测呈阳性。实施GBS预防指南后，未检测到新的GBS病例，EOS发病率从2012 - 2013年的每1000例活产1.9例（95%CI 1.3 - 2.8）降至2014年 - 2015年九月的每1000例活产1.3例（95%CI 0.7 - 2.3）（p = 0.32）。
尽管EOS发病率的降低不显著，但孕妇中GBS定植率较高，实施预防指南后未发生新生儿GBS病例。
