Abstract
ABSTRACTObjective:To analyze the incidence, complications, and hospital discharge status in newborns with ≥35 weeks of gestational age with early neonatal sepsis.Methods:This is a cross-sectional, retrospective study. Cases of early-onset sepsis registered from January 2016 to December 2019 in neonates with gestational age of 35 weeks or more were reviewed in a level III neonatal unit. The diagnoses were performed based on the criteria by the Brazilian Health Regulatory Agency (Anvisa), and the episodes were classified according to microbiological classification and site of infection. The following complications were evaluated: shock, coagulation disorders, and sequelae of the central nervous system. The conditions at hospital discharge were also assessed. The collected data were analyzed with the descriptive analysis.Results:In the period, early neonatal sepsis occurred in 46 newborns, corresponding to 1.8% of all newborns admitted to the neonatal unit, with a prevalence of 4/1,000 live births. Culture confirmed sepsis ocurred in three patients (0.3/1,000 live births), with the following agents: S. pneumoniae, S. epidermidis and S. agalactiae. As to site of infection, there were 35 cases of primary bloodstream infection, seven cases of pneumonia and four cases of meningitis. Most patients (78.3%) had at least one risk factor for sepsis, and all were symptomatic at admission. There were no deaths. Complications occurred in 28.2% of the cases, especially shock (10 cases – 21.7%).Conclusions:The prevalence of proven early neonatal sepsis was low. Despite the common occurrence of complications, there were no deaths.
Highlights
Neonatal sepsis (ENS) affects a significant number of newborns (NB), and is associated with increasing morbidity and mortality rates in the first week of life
The incidence of Early neonatal sepsis (ENS) in infants born at term is of approximately 0.5/1,000 live births; this number doubles among late preterm newborns (PTNB), and is even more significant in PTNB
The prevalence of ENS found in this study is similar to the numbers found in a recent North-American study, in which the rate of ENS ranged from 1 to 4/1,000 live births, depending on the region of the USA and the time of assessment.[12]
Summary
Neonatal sepsis (ENS) affects a significant number of newborns (NB), and is associated with increasing morbidity and mortality rates in the first week of life. It is estimated that the infection is responsible for 27.5% of neonatal deaths, reaching rates as high as 20/1,000 live births in countries with high neonatal mortality rates. It is known that the data are inaccurate, especially in developing countries, where many deaths occur in the household, without medical assistance.[1] In Brazil, the records of neonatal sepsis as a cause of death add up to approximately 3,000 infants per year.[2] The unfavorable outcome ranges according to gestational age, and prematurity is an additional risk factor.[3]. The incidence of ENS in infants born at term is of approximately 0.5/1,000 live births; this number doubles among late preterm newborns (PTNB), and is even more significant in PTNB
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