Oyato Befekadu Tesfaye, Sime Teshome Ketema, Debele Tirunesh, Abasimel Husen Zakir, Alemu Fikadu Tolesa, Asfaw Samuel Boja, Mekonnin Wuletaw Tadesse, Gesisa Hana Israel, Kebede Elleni Tesfaye
Department of Midwifery, College of Health Sciences, Salale University, Fiche, Ethiopia.
Department of Medical laboratory, College of Health Sciences, Salale University, Fiche, Ethiopia.
BMC Infect Dis. 2025 Jan 24;25(1):113. doi: 10.1186/s12879-025-10525-1.
Neonatal sepsis remains one of the most common causes of morbidity and mortality among neonates in developing countries. It can cause severe morbidities and sequelae, even though patients survive. Prolonged recovery time of neonatal sepsis leads to hospitalization, increased cost of treatments, antimicrobial resistance, disseminated intravascular coagulation, respiratory failure, septic shock, brain lesions, renal failure, and cardiovascular dysfunction, and eventually death. Thus, this study aimed to identify the time-to-recovery of neonatal sepsis and its predictors among newborns admitted to public hospitals in the North Shoa Zone, Central Ethiopia.
A retrospective cohort study was conducted among 508 septic neonates admitted to selected public hospitals in the North Shoa Zone between March 1, 2021, and March 1, 2023. A systematic random sampling method was used to select eligible medical records. The data were collected through the open data kit (ODK) Collect Android app and consequently exported to STATA version 17 for analysis. The data were analyzed using both univariable and multivariable Cox regression models. The adjusted hazard ratio (AHR) with its corresponding 95% confidence interval (CI) was employed.
Of all septic neonates, 441 were recovered. The predictors of time-to-recovery of neonatal sepsis were premature rupture of membrane (PROM) (AHR = 0.37; 95% CI: 0.21, 0.63), intrapartum fever (AHR = 0.49; 95% CI: 0.32, 0.75), chest-indrawing (AHR = 0.50; 95% CI: 0.36, 0.68), fifth-minute appearance, pulse, grimace, activity, and respiration (Apgar) score less than seven (AHR = 0.54; 95% CI: 0.38, 0.77), gestational age between 37 and 42 weeks (AHR = 1.35; 95% CI: 1.06, 1.70), septic shock (AHR = 0.52; 95% CI: 0.31, 0.85).
The median time to recovery from neonatal sepsis in this study was comparable to the previous studies. Premature rupture of membranes, intrapartum fever, term gestational age, low fifth minute Apgar score, chest indrawing, and septic shock were the predictors of time-to recovery of neonatal sepsis. Therefore, birth attendants are advised to closely adhere to the obstetrics management protocols when providing care for women who have intrapartum fever and premature rupture of membranes, as this will help to minimize neonatal sepsis and the subsequent delay in recovery.
在发展中国家，新生儿败血症仍然是新生儿发病和死亡的最常见原因之一。即使患者存活，它也可能导致严重的发病和后遗症。新生儿败血症的恢复时间延长会导致住院时间延长、治疗费用增加、抗菌药物耐药性、弥散性血管内凝血、呼吸衰竭、感染性休克、脑损伤、肾衰竭和心血管功能障碍，最终导致死亡。因此，本研究旨在确定埃塞俄比亚中部北绍阿地区公立医院收治的新生儿败血症的恢复时间及其预测因素。
对2021年3月1日至2023年3月1日期间在北绍阿地区选定公立医院收治的508例败血症新生儿进行回顾性队列研究。采用系统随机抽样方法选择符合条件的病历。数据通过开放数据工具包（ODK）Collect安卓应用程序收集，随后导出到STATA 17版本进行分析。使用单变量和多变量Cox回归模型进行数据分析。采用调整后的风险比（AHR）及其相应的95%置信区间（CI）。
在所有败血症新生儿中，441例康复。新生儿败血症恢复时间的预测因素包括胎膜早破（PROM）（AHR = 0.37；95%CI：0.21，0.63）、产时发热（AHR = 0.49；95%CI：0.32，0.75）、吸气三凹征（AHR = 0.50；95%CI：0.36，0.68）、出生后第五分钟的外观、脉搏、皱眉、活动和呼吸（Apgar）评分低于7分（AHR = 0.54；95%CI：0.38，0.77）、孕龄在37至42周之间（AHR = 1.35；95%CI：1.06，1.70）、感染性休克（AHR = 0.52；95%CI：0.31，0.85）。
本研究中新生儿败血症的中位恢复时间与先前的研究相当。胎膜早破、产时发热、足月孕龄、出生后第五分钟Apgar评分低、吸气三凹征和感染性休克是新生儿败血症恢复时间的预测因素。因此，建议助产人员在为产时发热和胎膜早破的妇女提供护理时，严格遵守产科管理方案，因为这将有助于最大限度地减少新生儿败血症及随后的恢复延迟。
