Kolesnichenko Svetlana I, Kadyrova Irina A, Lavrinenko Alyona V, Zhumadilova Zhibek A, Avdienko Olga V, Vinogradskaya Yelena V, Fominykh Yevgeniy A, Panibratec Lyudmila G, Akhmaltdinova Lyudmila L
Shared Resource Laboratory, Research Centre, Karaganda Medical University, Karaganda, Kazakhstan.
Regional Clinical Hospital of Karaganda, Perinatal Center No. 1, Karaganda, Kazakhstan.
Infect Drug Resist. 2022 Oct 31;15:6307-6316. doi: 10.2147/IDR.S390723. eCollection 2022.
This study aimed to determine predisposing factors for negative outcome in infants with early neonatal sepsis during COVID-19.
A prospective cohort study of 172 newborns up to 4 days diagnosed with neonatal sepsis was carried out in Karaganda (Kazakhstan). The microbiological examination was used to identify a causative agent of bloodstream infection. ELISA was performed to determine the total anti-SARS-CoV-2 antibodies. Gestational age, mode of delivery, birth weight, C-reactive protein and procalcitonin levels, comorbidities, type of pathogen, duration of hospitalization and mother's infection diseases were used for statistical analysis.
Mortality in infants with neonatal sepsis was 22% (38/172). Anti-SARS-CoV-2 antibodies were detected in 68.3% of the newborns. Culture-negative ELBW infants have a 5.3-fold higher risk of death (p<0.001). Low gestational age and a shorter period of hospitalization were statistically associated with fatality. CRP is generally higher in deceased children (p=0.002). Necrotizing enterocolitis (p<0.001), pneumonia (p=0.009) and anemia (p=0.016) were significantly associated with negative outcome. And, 31.4% of the infants with sepsis had positive blood cultures. The leading cause of sepsis in newborns was CoNS - 57%.
During COVID-19 pandemic neonatal sepsis mortality was associated with low birth weight, gestational age, and comorbidities as in non-pandemic time. The relationship between COVID-19 in the mother and neonatal mortality was not found. However, anti-SARS-CoV-2 antibodies were detected in more than half of newborns.
本研究旨在确定新冠疫情期间早发型新生儿败血症患儿不良结局的诱发因素。
在哈萨克斯坦卡拉干达对172名出生4天以内诊断为新生儿败血症的新生儿进行了一项前瞻性队列研究。采用微生物学检查来确定血流感染的病原体。进行酶联免疫吸附测定（ELISA）以测定抗SARS-CoV-2抗体的总量。对胎龄、分娩方式、出生体重、C反应蛋白和降钙素原水平、合并症、病原体类型、住院时间和母亲的感染性疾病进行统计分析。
新生儿败血症患儿的死亡率为22%（38/172）。68.3%的新生儿检测到抗SARS-CoV-2抗体。血培养阴性的极低出生体重儿死亡风险高5.3倍（p<0.001）。低胎龄和较短的住院时间与死亡在统计学上相关。死亡儿童的C反应蛋白通常较高（p=0.002）。坏死性小肠结肠炎（p<0.001）、肺炎（p=0.009）和贫血（p=0.016）与不良结局显著相关。并且，31.4%的败血症患儿血培养呈阳性。新生儿败血症的主要病因是凝固酶阴性葡萄球菌——占57%。
在新冠疫情期间，新生儿败血症死亡率与低出生体重、胎龄和合并症有关，与非疫情时期相同。未发现母亲感染新冠病毒与新生儿死亡率之间的关系。然而，超过半数的新生儿检测到抗SARS-CoV-2抗体。
