MICROBIOLOGICAL ANALYSIS AND FACTORS ASSOCIATED WITH SEPSIS
IN NEONATAL INTENSIVE CARE UNITS (NICU)
Name: IARA SANTOS REIS
Publication date: 25/03/2024
Examining board:
Name |
Role |
|---|---|
| CREUZA RACHEL VICENTE | Examinador Interno |
| RICARDO PINTO SCHUENCK | Presidente |
| THIAGO CÉSAR NASCIMENTO | Examinador Externo |
Summary: Sepsis is considered one of the main causes of morbidity and mortality in newborns. The treatment of neonatal sepsis (NS) has become an even greater challenge with the advancement of microbial resistance, which is a problem of global importance. The present work aimed to analyze the associated factors and the microbiological profile of NS in patients admitted to neonatal intensive care units (NICUs) of different private tertiary hospitals located in the State of Espírito Santo. The collection of clinical data on neonates, maternal and microbiological data were collected through the electronic medical records of each hospital between 2016 and 2021. Neonatal sepsis cases were divided into two groups, according to the onset of symptoms: early-onset neonatal sepsis (NPS), which occurred within 72 hours of life; and late-onset (SNT), which occurred after 72 hours of life and up to 28 days after birth. A total of 177 newborns presented NS, with a prevalence of TNS (n = 133 / 75.13%). Factors such as prematurity (p = 0.042), low birth weight (p = 0.001), Apgar score at 1 minute (p = 0.02), resuscitation at birth (p = 0.008), use of a venous catheter (p = 0.032), use of peripherally inserted central venous catheter (PICC) (p = 0.001) and length of stay (p = 0.001) showed a significant difference between SNP and SNT. The mortality rate was 15.82% and factors such as gestational age, days of mechanical ventilation use and length of hospital stay were associated with the outcome of death. 217 microorganisms were isolated from blood cultures, with Gram-positive bacteria (n = 119 / 54.84%), followed by Gram-negative bacteria (n = 82 / 37.79%) and fungi (n = 7.37%) being prevalent. . Overall, coagulase-negative Staphylococcus (CNS) was more common in both SNP and SNT. Gram-negative bacteria, notably Klebsiella pneumoniae, were only relevant in cases of TNS. High rates of resistance among antibiotics were observed in both Gram-positive and negative bacteria, with over 70% of isolates being considered multidrug resistant (MDR). The mortality rate was significantly higher among newborns with NTS, highlighting the importance of implementing and reinforcing compliance with healthcare-related infection prevention measures in NICUs. The study highlights the importance of systematic monitoring of agents causing neonatal sepsis and their antimicrobial susceptibility profile, as we observed important variations in relation to SNT and SNP.
