SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE.
TERNOPIL PERINATAL CENTER, TERNOPIL, UKRAINE.
Wiad Lek. 2021;74(9 cz 1):2025-2032.
The aim: To obtain the estimates of the сurrent incidence rate of perinatal infections, risk factors, as well as their associated impact on mortality and determine the antimicrobial resistance of responsible pathogens in Ukraine.
Materials and methods: We performed a multicentre retrospective cohort study was based on surveillance data. This study included infants aged 0 to 6 days delivered in 2017-2019 at 11 Ukrainian regional perinatal centers. Definitions of perinatal infections and mortality were used from the CDC/WHO/UNICEF.
Results: Of 18,348 liveborn infants, 472 (2.6%) perinatal infections were detected. The incidence of perinatal infection was 25.7 per 1000 live births. The most frequently identified types of infections were: bloodstream infections, 35.6 %, lower respiratory tract infections, 21.4%, Meningitis, 18.2%, Conjunctivitis, 11.9%, skin and soft tissue infections, 6.6%, Dacryocystitis, 3.8%, and urinary tract infections, 2.5%. Early mortality rates from perinatai infections was 51.1%, with an incidence of 13.1 deaths/1000 live births. Potential risk factors the development of perinatal infections and mortality were low birth weight, prematurity, low gestasional age, mode of delivery (manual aid), premature rupture of membranes, preterm premature rupture of membranes, prolonged rupture of membranes, turbid and meconeal amniotic fluid, infection of the mother during labor. resuscitation during delivery, invasive procedure, asphyxia. Main causative agents of perinatal infections were Escherichia coli, Streptococcus agalactiae, Staphylococcus aureus, Klebsiella pneumoniae, CoNS, Enterobacter cloacae, Pseudomonas aeruginosa.
Conclusions: This study showing that the high incidence rate of perinatal bacterial infections, as well as their associated impact on mortality, and presents a significant burden to the Ukraine.
旨在获得围产期感染的当前发病率、危险因素的估计值,以及它们对死亡率的相关影响,并确定乌克兰负责病原体的抗菌药物耐药性。
材料和方法:我们进行了一项基于监测数据的多中心回顾性队列研究。该研究纳入了 2017 年至 2019 年在乌克兰 11 个地区围产期中心分娩的 0 至 6 天龄的婴儿。围产期感染和死亡率的定义来自疾病预防控制中心/世界卫生组织/联合国儿童基金会。
结果:在 18348 例活产婴儿中,发现 472 例(2.6%)围产期感染。围产期感染的发病率为每 1000 例活产 25.7 例。最常见的感染类型为:血流感染,35.6%,下呼吸道感染,21.4%,脑膜炎,18.2%,结膜炎,11.9%,皮肤和软组织感染,6.6%,泪囊炎,3.8%,尿路感染,2.5%。围产期感染的早期死亡率为 51.1%,发病率为每 1000 例活产 13.1 例死亡。围产期感染和死亡的潜在危险因素是低出生体重、早产、低胎龄、分娩方式(手助)、胎膜早破、早产胎膜早破、胎膜延长破裂、羊水浑浊和胎粪、产妇产时感染、分娩时复苏、有创操作、窒息。围产期感染的主要病原体为大肠杆菌、无乳链球菌、金黄色葡萄球菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌、阴沟肠杆菌、铜绿假单胞菌。
本研究表明,乌克兰围产期细菌感染的发病率较高,对死亡率有相关影响,对乌克兰造成了重大负担。