Sorsa Abebe
Department of pediatrics and child health Arsi University College of Health Science, Asella, Ethiopia.
Ethiop J Health Sci. 2019 May;29(3):333-342. doi: 10.4314/ejhs.v29i3.5.
Globally, sepsis remains one of the major causes of morbidity and mortality in neonates, in spite of recent advances in health care units. The major burden of the problem occurs in the developing world while most evidence is derived from developed countries. The objective of this study was to evaluate the epidemiology of neonatal sepsis and associated factors among neonates admitted to Neonatal Intensive Care Unit (NICU).
Hospital based prospective cross-sectional study was conducted from April 2016 to May 2017. Neonates with clinical sepsis were included into the study. Data were analyzed using SPSS version 20. Frequencies, proportion and summary statistics were used to describe the study population in relation to relevant variables. Multivariate logistic regressions were used to assess factors associated with neonatal sepsis. p-values of < 0.05 were considered statistically significant.
A total of 901neonates were admitted to NICU of which 303 neonates were admitted with diagnosis of clinical sepsis making the prevalence of neonatal sepsis to be 34%. Bacteremia were confirmed in 88/303(29.3%) of clinical sepsis, and gram-positive bacteria constituted 47/88(53.4%). Of all positive blood cultures, 52/88(59.1%) were reported from late onset sepsis. Coagulase negative staphylococcus (CoNS) accounted for 22/88(25%) followed by E. coli and S. aureus, each contributing 18/88(20.3%) and 16/88(18.2%) respectively. Prolonged PROM, low fifth Apgar score, prematurity and low birth weight were strongly associated with increased risk of neonatal sepsis. Neonates born to mothers who received antibiotics during labor and delivery were at significantly lower risk of acquiring neonatal sepsis.
The prevalence of neonatal sepsis was high, and most causes of neonatal sepsis were gram positive bacteria and most bacteria isolates were from late onset sepsis. Obstetric factors were strongly associated with development of neonatal sepsis. Intrapartal antibiotic administration significantly reduces neonatal sepsis.
在全球范围内，尽管医疗保健单位最近取得了进展，但败血症仍然是新生儿发病和死亡的主要原因之一。该问题的主要负担发生在发展中世界，而大多数证据来自发达国家。本研究的目的是评估新生儿重症监护病房（NICU）收治的新生儿败血症的流行病学及相关因素。
于2016年4月至2017年5月进行了一项基于医院的前瞻性横断面研究。纳入有临床败血症的新生儿。使用SPSS 20版进行数据分析。频率、比例和汇总统计用于描述研究人群与相关变量的关系。多变量逻辑回归用于评估与新生儿败血症相关的因素。p值<0.05被认为具有统计学意义。
共有901名新生儿入住NICU，其中303名新生儿被诊断为临床败血症，新生儿败血症的患病率为34%。88/303（29.3%）的临床败血症病例确诊为菌血症，革兰氏阳性菌占47/88（53.4%）。在所有阳性血培养中，52/88（59.1%）报告自晚发性败血症。凝固酶阴性葡萄球菌（CoNS）占22/88（25%），其次是大肠杆菌和金黄色葡萄球菌，各占18/88（20.3%）和16/88（18.2%）。胎膜早破时间延长、阿氏评分低、早产和低出生体重与新生儿败血症风险增加密切相关。在分娩期间接受抗生素治疗的母亲所生的新生儿患新生儿败血症的风险显著降低。
新生儿败血症的患病率很高，新生儿败血症的大多数病因是革兰氏阳性菌，大多数细菌分离株来自晚发性败血症。产科因素与新生儿败血症的发生密切相关。产时抗生素给药可显著降低新生儿败血症。
