Car Kathleen P, Nakwa Firdose, Solomon Fatima, Velaphi Sithembiso C, Tann Cally J, Izu Alane, Lala Sanjay G, Madhi Shabir A, Dangor Ziyaad
Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
South African Medical Research Council: Vaccines and Infectious Diseases Analytical Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Perinatol. 2022 Mar;42(3):354-358. doi: 10.1038/s41372-021-01290-5. Epub 2022 Jan 10.
We evaluated the association between early-onset sepsis and neonatal encephalopathy in a low-middle-income setting.
We undertook a retrospective study in newborns with gestational age ≥35 weeks and/or birth weight ≥2500 grams, diagnosed with neonatal encephalopathy. Early-onset sepsis was defined as culture-confirmed sepsis or probable sepsis.
Of 10,182 hospitalised newborns, 1027 (10.1%) were diagnosed with neonatal encephalopathy, of whom 52 (5.1%) had culture-confirmed and 129 (12.5%) probable sepsis. The case fatality rate for culture-confirmed sepsis associated neonatal encephalopathy was threefold higher compared to neonatal encephalopathy without sepsis (30.8% vs. 10.5%, p < 0.001). Predictors of mortality for culture-confirmed sepsis associated neonatal encephalopathy included severe neonatal encephalopathy (aOR 6.51, 95%CI: 1.03-41.44) and seizures (aOR 10.64, 95%CI: 1.05-107.39).
In this setting, 5% of neonatal encephalopathy cases was associated with culture-confirmed sepsis and a high case fatality rate.
我们评估了中低收入环境下早发型败血症与新生儿脑病之间的关联。
我们对孕周≥35周和/或出生体重≥2500克、被诊断为新生儿脑病的新生儿进行了一项回顾性研究。早发型败血症被定义为血培养确诊的败血症或疑似败血症。
在10182名住院新生儿中，1027名（10.1%）被诊断为新生儿脑病，其中52名（5.1%）血培养确诊败血症，129名（12.5%）疑似败血症。血培养确诊败血症相关的新生儿脑病的病死率比无败血症的新生儿脑病高三倍（30.8%对10.5%，p＜0.001）。血培养确诊败血症相关的新生儿脑病的死亡预测因素包括重度新生儿脑病（调整后比值比6.51，95%置信区间：1.03 - 41.44）和癫痫发作（调整后比值比10.64，95%置信区间：1.05 - 107.39）。
在这种环境下，5%的新生儿脑病病例与血培养确诊的败血症相关，且病死率很高。
