Hospital Materno Infantil de Brasília, Health Secretariat of Distrito Federal,Brasilia,Brazil.
Nucleo de Medicina Tropical, University of Brasilia,Brasilia,Brazil.
Epidemiol Infect. 2019 Jan;147:e208. doi: 10.1017/S095026881900092X.
A cohort study was performed from January 2014 to December 2016 in a Brazilian neonatal intensive care unit, including neonates with high risk for infection and death. We estimated bloodstream infection (BSI) incidence and conducted a survival analysis, considering the time to death and to the first episode of BSI as outcomes, comparing very low birth weight (VLBW) neonates with the remaining neonates. An extended Cox model was performed and the hazard ratio (HR) was calculated for different time periods. The study had 1560 neonates included, the incidence and the incidence density of BSI was 22% and 18.6 per 1000 central venous catheter-days, respectively. Considering VLBW neonates as the reference group, the HR for time to death was 4.06 (95% CI 2.75-6.00, P < 0.01) from day 0 to 60 and for time to the first episode of BSI was 1.76 (95% CI 1.31-2.36, P < 0.01) from day 0 to 36. Having the heavier neonates group as reference, the HR for time to the first episode of BSI was 2.94 (95% CI 1.92-4.34, P < 0.01) from day 37 to 90. Late-onset neonatal sepsis prevention measures should consider the differences in risk during time, according to neonates' birth weight.
一项队列研究于 2014 年 1 月至 2016 年 12 月在巴西新生儿重症监护病房进行，纳入了具有感染和死亡高风险的新生儿。我们估计血流感染（BSI）的发生率并进行了生存分析，以死亡时间和首次 BSI 发作时间为结局，比较极低出生体重（VLBW）新生儿和其余新生儿。进行了扩展 Cox 模型，计算了不同时间段的风险比（HR）。该研究共纳入 1560 名新生儿，BSI 的发生率和发生率密度分别为 22%和 18.6/1000 中心静脉导管日。将 VLBW 新生儿作为参考组，从第 0 天到第 60 天，死亡时间的 HR 为 4.06（95%CI 2.75-6.00，P < 0.01），从第 0 天到第 36 天，首次 BSI 发作时间的 HR 为 1.76（95%CI 1.31-2.36，P < 0.01）。以较重的新生儿组为参考，从第 37 天到第 90 天，首次 BSI 发作时间的 HR 为 2.94（95%CI 1.92-4.34，P < 0.01）。应根据新生儿的出生体重，考虑不同时间的风险差异，采取预防晚发型新生儿败血症的措施。
