Zavaleta Hector, Cordero Guadalupe, Edwards Erika M, Flannery Dustin D
Department of Neonatology, Instituto Nacional de Perinatología, Mexico City, Mexico.
Vermont Oxford Network, Burlington, Vermont.
Am J Perinatol. 2025 May 28. doi: 10.1055/a-2601-8982.
This study aimed to describe the epidemiology, pathogens, and outcomes associated with early-onset and late-onset sepsis among newborns admitted to the leading public neonatal hospital in Mexico.We conducted a retrospective cohort study of infants admitted to the neonatal intensive care unit (NICU) at the Instituto Nacional de Perinatología in Mexico City from 2018 to 2023. Early-onset sepsis (EOS) was defined as a culture-confirmed bacterial infection of blood or cerebrospinal fluid within 3 days of birth, and late-onset sepsis (LOS) as culture-confirmed bacterial or fungal infection after day 3. Descriptive statistics and logistic regression were used to compare characteristics and outcomes among infants with and without EOS/LOS.Among 4,381 admitted infants, 23 (0.5%) had EOS (5.2 per 1,000 admissions), and 444 of 3,950 (11.2%) who survived >3 days had LOS (112.4 per 1,000). Prematurity was a major risk factor. accounted for 70% of EOS, and coagulase-negative staphylococci and spp. were the leading causes of LOS. Infections were associated with higher morbidity, longer hospitalization, and reduced survival, though mortality differences were not statistically significant after adjustment.Neonatal sepsis remains a major burden in this Mexican NICU, with a predominance of gram-negative organisms and incidence rates higher than recent U.S. reports. Continued surveillance and antimicrobial stewardship are warranted to guide empiric therapy and track resistance patterns. · Prematurity was a major risk factor for both early- and late-onset sepsis.. · Gram-negative organisms, especially Escherichia coli and Klebsiella species, were the predominant pathogens.. · Sepsis was associated with increased morbidity, prolonged hospitalization, and lower survival..
本研究旨在描述墨西哥主要公立新生儿医院收治的新生儿早发型和晚发型败血症的流行病学、病原体及相关结局。我们对2018年至2023年在墨西哥城国家围产医学研究所新生儿重症监护病房（NICU）收治的婴儿进行了一项回顾性队列研究。早发型败血症（EOS）定义为出生后3天内血培养或脑脊液培养确诊的细菌感染，晚发型败血症（LOS）定义为出生3天后培养确诊的细菌或真菌感染。采用描述性统计和逻辑回归比较有无EOS/LOS婴儿的特征和结局。在4381名收治婴儿中，23名（0.5%）患有EOS（每1000例入院中有5.2例），在3950名存活超过3天的婴儿中，444名（11.2%）患有LOS（每1000例中有112.4例）。早产是主要危险因素。EOS病例中70%为早产儿，凝固酶阴性葡萄球菌和 菌属是LOS的主要病因。感染与更高的发病率、更长的住院时间和生存率降低相关，尽管调整后死亡率差异无统计学意义。在这家墨西哥NICU中，新生儿败血症仍然是一个主要负担，革兰氏阴性菌占主导，发病率高于美国近期报告。有必要持续进行监测和抗菌药物管理，以指导经验性治疗并追踪耐药模式。·早产是早发型和晚发型败血症的主要危险因素。·革兰氏阴性菌，尤其是大肠杆菌和克雷伯菌属，是主要病原体。·败血症与发病率增加、住院时间延长和生存率降低相关。
