Ortiz de Zárate Marcela, Sáenz Carolina, Cimbaro Canella Raúl, Díaz Marcela, Mucci Josefina, Dinerstein Alejandro, Solana Claudio
Hospital Materno Infantil Ramón Sardá. City of Buenos Aires, Argentina.
Arch Argent Pediatr. 2023 Jun 1;121(3):e202202779. doi: 10.5546/aap.2022-02779.eng. Epub 2023 Feb 9.
Introduction. Neonatal sepsis is often suspected in hospitalized newborn infants, but only in 25-30% of cases it is confirmed via a positive culture. Selecting the antibiotics based on local epidemiology favors their rational use and minimizes their side effects. Primary objective. To describe the prevalence of early- and late-onset sepsis with microorganism isolation and their clinical characteristics. Population and method. Retrospective, cross-sectional study conducted between 01-01-2013 and 12-31-2017 in a public maternity center of Argentina in all hospitalized newborn infants with a diagnosis of early- and late-onset sepsis with microorganism isolation, and those re-admitted in their first month of life. Results. A total of 3322 newborn infants were admitted; 1296 were assessed for suspected early- onset sepsis; 25 had a positive culture (1.9%; rate: 0.86‰). Of these, 52% were born before 33 weeks of gestation. Microorganisms: Escherichia coli 5, Listeria monocytogenes 4, Streptococcus agalactiae (SGB) 3, Streptococcus pneumoniae 3. Also, 68% of late-onset sepsis cases (rate: 8.73‰) occurred in infants born before 33 weeks of gestation. Hospital-acquired microorganisms: coagulase-negative Staphylococcus 115, Staphylococcus aureus 47, Escherichia coli 30, Candida spp. 16, Enterococcus faecalis 13, Klebsiella pneumoniae 11, and Streptococcus agalactiae 10. In re-admissions: E. coli 11, S. aureus 12, SGB 3, and Haemophilus influenzae 3. Conclusions. During the study period, the frequency of early-onset sepsis was similar to international reports, with a predominance of E. coli and L. monocytogenes. The rate of late-onset sepsis showed a downward trend in the analyzed years, with a predominance of Gram-positive cocci.
引言。住院新生儿常被怀疑患有新生儿败血症,但只有25% - 30%的病例通过阳性培养得以确诊。根据当地流行病学情况选择抗生素有利于合理使用并将其副作用降至最低。主要目标。描述伴有微生物分离的早发型和晚发型败血症的患病率及其临床特征。研究对象与方法。2013年1月1日至2017年12月31日在阿根廷一家公立产科中心对所有诊断为伴有微生物分离的早发型和晚发型败血症的住院新生儿以及出生后第一个月内再次入院的新生儿进行回顾性横断面研究。结果。共收治3322例新生儿;对1296例疑似早发型败血症患儿进行了评估;25例培养结果呈阳性(1.9%;发病率:0.86‰)。其中,52%的患儿在妊娠33周前出生。微生物种类:大肠杆菌5例,单核细胞增生李斯特菌4例,无乳链球菌(SGB)3例,肺炎链球菌3例。此外,68%的晚发型败血症病例(发病率:8.73‰)发生在妊娠33周前出生的婴儿中。医院获得性微生物:凝固酶阴性葡萄球菌115例,金黄色葡萄球菌47例,大肠杆菌30例,念珠菌属16例,粪肠球菌13例,肺炎克雷伯菌11例,无乳链球菌10例。再次入院病例中:大肠杆菌11例,金黄色葡萄球菌12例,SGB 3例,流感嗜血杆菌3例。结论。在研究期间,早发型败血症的发生率与国际报告相似,以大肠杆菌和单核细胞增生李斯特菌为主。晚发型败血症的发病率在分析年份呈下降趋势,以革兰氏阳性球菌为主。