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1.
Arch. pediatr. Urug ; 92(2): e212, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1339132

ABSTRACT

Introducción: la sepsis tardía por estafilococo coagulasa negativo (SCoN) es una causa común de morbimortalidad en la unidad neonatal. Los SCoN son los microorganismos más frecuentemente involucrados con aproximadamente el 50% de los casos. El objetivo de este estudio es analizar la incidencia y las características de los neonatos portadores de sepsis tardía por SCoN. Materiales y métodos: se realizó un estudio descriptivo, longitudinal, retrospectivo. Se utilizaron las bases de datos del laboratorio de microbiología del hospital y las historias clínicas electrónicas para obtener la información. El período de estudio analizado fueron los años 2018 y 2019 en la unidad de cuidados intensivos e intermedios de recién nacidos del Centro Hospitalario Pereira Rossell. Resultados: obtuvimos una incidencia de 2,5% de los ingresos a cuidados intensivos e intermedios (25 pacientes). La edad gestacional al nacer fue de 28 semanas (25,0-35,0) y la mediana del peso fue de 1.070 g (730,0-2.365,0). La media de edad gestacional posmenstrual al momento del diagnóstico fue de 32,92±7,921 semanas. Por sospecha de sepsis precoz, 17 pacientes habían recibido un curso de antibióticos previo. El signo clínico más frecuentemente observado fue el deterioro del estado general, en 11 pacientes, seguido de distensión abdominal en 6 y fiebre en 5. Dentro de los SCoN, el más frecuentemente aislado fue el Staphylococcus epidermidis (13 pacientes); 22 pacientes recibieron tratamiento, 18 de ellos con vancomicina-meropenem y 4 con monoterapia con vancomicina. Conclusión: estos patógenos representan una causa importante de morbimortalidad en la unidad neonatal, particularmente en pacientes que presentan mayor gravedad y mayor necesidad de soporte vital. Se necesitan pautas claras de interpretación del rol de estos microorganismos y de abordaje de pacientes con riesgo de sepsis tardía, incluyendo el tratamiento antibiótico empírico.


Introduction: Coagulase Negative Staphylococci (CoNS) late onset sepsis is a common cause of morbidity and mortality in the neonatal intensive care unit (NICU). CoNS are the most frequently isolated microorganisms and total 50% of cases. The objective of this study is to analyze the incidence and characteristics of newborns carriers of late onset CoNS. Materials and methods: we performed a descriptive, retrospective, longitudinal study. Data was obtained from the hospital's microbiology laboratory database and electronic medical records. Patients included were those admitted to NICU during the period between 2018 and 2019. Results: we obtained an incidence of 2.5% of patients admitted to the NICU (25 patients). Median gestational age at birth was 28 weeks 25.0-35.0 and median birth weight was 1.070 g 730.0-2365.0. Mean gestational age at the time of diagnosis was 32.92±7.921 weeks. 17 patients had received an antibiotics course at birth because of early onset sepsis suspicion. The most frequently observed clinical symptom was deterioration of general condition, 11 patients, followed by abdominal distention in 6 and fever in 5. Among CoNS, the most frequently isolated pathogen was Staphylococcus epidermidis (13 patients). 22 patients received treatment, 18 a combination of vancomycin and meropenem and 4 received vancomycin monotherapy. Conclusion: these pathogens are a common cause of morbidity and mortality in the newborn intensive care unit, particularly in patients with more serious conditions and in those who require more advanced life support measures. Clearer interpretation of their role is needed as well as to determine a proper approach to patients at risk of late onset sepsis, including empiric antibiotic treatment.


Sepse tardia para Staphylococcus coagulase negativa (SCoN) é uma causa comum de morbidade e mortalidade na unidade neonatal. SCoNs são os microrganismos mais frequentemente envolvidos e representam aproximadamente 50% dos casos. O objetivo deste estudo é analisar a incidência e as características de neonatos com sepse tardia por SCoN. Materiais e métodos: foi realizado um estudo descritivo, longitudinal e retrospectivo. Usamos os bancos de dados do laboratório de microbiologia e prontuários médicos eletrônicos de nosso hospital para obter as informações. O período de estudo analisado foi de 2018 e 2019 na unidade de terapia intensiva e intermediária para recém-nascidos do Centro Hospitalar Pereira Rossell. Resultados: obtivemos uma incidência de 2,5% de internações em Terapia Intensiva e Intermediária (25 pacientes). A idade gestacional ao nascer foi de 28 semanas 25,0-35,0 e o peso médio foi de 1070g 730,0-2365,0. A média da idade gestacional pós-menstrual no momento do diagnóstico foi de 32,92 ± 7,921 semanas. 17 pacientes haviam recebido um curso anterior de antibióticos por suspeita de sepse precoce. O sinal clínico mais frequentemente observado foi deterioração do estado geral em 11 pacientes, seguido por distensão abdominal em 6 e febre em 5. Dentre os SCoN, o mais isolado foi o Staphylococcus Epidermidis (13 pacientes). 22 pacientes receberam tratamento, 18 deles com Vancomicina-Meropenem e 4 com Vancomicina em monoterapia. Conclusão: esses patógenos representam uma importante causa de morbimortalidade na unidade neonatal, principalmente em pacientes com maior gravidade e maior necessidade de suporte de vida. Orientações claras são necessárias para interpretar o papel desses microrganismos e para abordar pacientes com risco de sepse tardia, incluindo tratamento com antibióticos.


Subject(s)
Humans , Female , Infant, Newborn , Staphylococcal Infections/epidemiology , Neonatal Sepsis/epidemiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/virology , Uruguay/epidemiology , Vancomycin/therapeutic use , Cross Infection , Epidemiology, Descriptive , Incidence , Retrospective Studies , Longitudinal Studies , Coagulase , Staphylococcus haemolyticus/virology , Staphylococcus hominis/virology , Anti-Bacterial Agents/therapeutic use
2.
Arch. pediatr. Urug ; 92(2): e209, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278302

ABSTRACT

Introducción: el estreptococo del grupo B (EGB) es una causa frecuente de sepsis neonatal. La enfermedad precoz disminuyó su incidencia por la profilaxis antibiótica, a diferencia de la sepsis tardía, que aumentó su incidencia en los últimos años. Objetivo: conocer la incidencia de la sepsis tardía en el período 2016-2017 en el Centro Hospitalario Pereira Rossell (CHPR). El secundario, describir las características epidemiológicas y clínicas de sepsis tardía por EGB en niños ingresados a la Unidad de Cuidados Intensivos de Niños (UCIN) del CHPR en el período 2007-2017. Resultados: la incidencia calculada de sepsis tardía por EGB fue de 0,53 casos/1000 recién nacidos (RN) vivos. Entre los años 2007 y 2017 ingresaron cinco niños por sepsis tardía por EGB a la UCIN del CHPR. La presentación clínica más frecuentes fue fiebre sin foco y meningitis. Se obtuvieron tres aislamientos en sangre de EBG y tres en líquido cefalorraquídeo (dos en cultivo y otro por detección de ADN). Ninguno falleció. Los casos con meningitis presentaron alteraciones en la tomografía de cráneo. Un niño fue pretérmino. Conclusiones: la sepsis tardía se vincula a importante morbimortalidad en pediatría. No se ha establecido cuáles son los principales factores de riesgo asociados a una enfermedad grave ni las políticas para disminuir su incidencia.


Background: group B streptococcus (GBS) is a common cause of neonatal sepsis. Early disease decreased its incidence due to antibiotic prophylaxis. Late sepsis increased its incidence in recent years. Objectives: to know the incidence of late onset EGB sepsis in the period 2016-2017 at the Pereira Rossell Hospital Center (CHPR), and secondly, to describe the epidemiological characteristics and the clinical presentation of late onset sepsis due to GBS in children admitted to the Children's Intensive Care Unit (UCIN) of the CHPR in the period 2007-2017. Results: the calculated incidence of late sepsis due to GBS was 0.53 cases/1000 live newborns. Between 2007-2017, 5 children were admitted due to GBS late sepsis at the UCIN. The most frequent clinical presentation was fever without focus and meningitis. 3 isolates were obtained in EBG blood cultures and 3 in cerebrospinal fluid (2 in culture and another by DNA detection). None of them died. Cases with meningitis showed abnormalities in the brain tomography. 1 of the 5 was preterm. Conclusions: late sepsis is associated with significant morbidity and mortality in pediatric patients. The main risk factors associated with serious disease and the policies needed to reduce its incidence have not been established.


Introdução: o estreptococo do grupo B (SGB) é uma causa frequente de sepse neonatal. A doença precoce diminuiu sua incidência devido à profilaxia antibiótica, ao contrário da sepse tardia, que aumentou sua incidência nos últimos anos. Objetivo: conhecer a incidência de sepse tardia no período 2016-2017 no Centro Hospitalar Pereira Rossell (CHPR) e descrever as características epidemiológicas e clínicas da sepse tardia por SGB em crianças internadas na Unidade de Terapia Intensiva Infantil (UTIN) do CHPR no período de 2007-2017. Resultados: a incidência calculada de sepse tardia por SGB foi de 0,53 casos/1000 recém-nascidos vivos (RNs). Entre 2007-2017, 5 crianças foram internadas na UTIN do CHPR por sepse tardia devido a GBS. A apresentação clínica mais frequente foi febre sem causa e meningite. 3 isolados de EBG foram obtidos no sangue e 3 no líquido cefalorraquidiano (2 em cultura e outro por detecção de DNA). Nenhum dos pacientes morreu. Os casos com meningite apresentaram alterações na tomografia de crânio. Uma criança era pré-termo. Conclusões: a sepse tardia está associada a significativa morbimortalidade em pediatria. Os principais fatores de risco associados a uma doença grave e as políticas para reduzir sua incidência ainda não foram estabelecidas.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Streptococcal Infections/epidemiology , Neonatal Sepsis/etiology , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Uruguay/epidemiology , Catastrophic Illness , Epidemiology, Descriptive , Incidence , Retrospective Studies
3.
Infectio ; 25(2): 130-134, abr.-jun. 2021. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250079

ABSTRACT

Resumen El género Malassezia comprende levaduras lipofílicas, comensales de la piel de humanos y animales, responsables de infecciones dermatológicas y sistémicas, particularmente en recién nacidos pretérmino hospitalizados en Unidades de Cuidados Intensivos Neonatal (UCIN) con catéteres venosos centrales, antibióticos de amplio espectro y nutrición parenteral rica en lípidos. La información acerca de las fungemias por este microorganismo es limitada, sin embargo, la mayoría de infecciones invasivas reportadas en la literatura han sido asociadas con M. furfur y M. pachydermatis. Se reporta un caso de fungemia por M. sympodialis en un recién nacido pretérmino hospitalizado en la UCIN de un hospital colombiano con sospecha clínica de sepsis neonatal, antibioticoterapia de amplio espectro y hemocultivos de rutina negativos. El aislamiento fue susceptible a fluconazol y voriconazol, y resistente a anfotericina B. Existen pocos reportes de fungemia producida por M. sympodialis, pero todos concuerdan en que es una levadura subestimada en individuos con factores predisponentes.


Abstract The genus Malassezia comprises lipophilic yeasts, commensals of the skin of humans and animals, responsible for dermatological and systemic infections, particu larly in preterm infants hospitalized in Neonatal Intensive Care Units (NICU) with central venous catheters, broad-spectrum antibiotics and parenteral nutrition rich in lipids. Information about fungemia by this microorganism is limited, however, the majority of invasive infections reported in the literature have been associated with M. furfur and M. pachydermatis. A case of M. sympodialis fungemia is reported in a preterm newborn hospitalized in the NICU of a Colombian hospital with clinical suspicion of neonatal sepsis, broad-spectrum antibiotic therapy and negative routine blood cultures. The isolation was susceptible to fluconazole and voriconazole, and resistant to amphotericin B. There are few reports of fungemia produced by M. sympodialis, but all agree that it is an underestimated yeast in individuals with predisposing factors.


Subject(s)
Humans , Male , Infant, Newborn , Intensive Care Units, Neonatal , Fungemia , Malassezia , Skin , Yeasts , Colombia , Neonatal Sepsis , Infections
4.
Article in Chinese | WPRIM | ID: wpr-879897

ABSTRACT

OBJECTIVE@#To evaluate the efficacy of sepsis risk calculator (SRC) in guiding antibiotic use in neonates with suspected early-onset sepsis (EOS).@*METHODS@#A total of 284 neonates with a gestational age of ≥ 35 weeks were enrolled as the control group, who were hospitalized in the Children's Hospital of Chongqing Medical University from March to July, 2019 and were suspected of EOS. Their clinical data were retrospectively collected and the use of antibiotics was analyzed based on SRC. A total of 170 neonates with a gestational age of ≥ 35 weeks were enrolled as the study group, who were admitted to the hospital from July to November, 2020 and were suspected of EOS. SRC was used prospectively for risk scoring to assist the decision making of clinical antibiotic management. The two groups were compared in terms of the rate of use of antibiotics, blood culture test rate, clinical outcome, and adherence to the use of SRC.@*RESULTS@#Compared with the control group, the study group had a significantly higher SRC score at birth and on admission (@*CONCLUSIONS@#The use of SRC reduces the rate of empirical use of antibiotics in neonates with suspected EOS and does not increase the risk of adverse outcomes, and therefore, it holds promise for clinical application.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Child , Humans , Infant , Infant, Newborn , Neonatal Sepsis/drug therapy , Retrospective Studies , Risk Assessment , Sepsis/drug therapy
5.
Braz. j. med. biol. res ; 54(7): e10603, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249320

ABSTRACT

Neonatal sepsis is an inflammatory system syndrome and a main cause of neonatal mortality. However, there is a lack of ideal biomarkers for early neonatal sepsis diagnosis. The aim of this study was to evaluate the clinical significance of miR-141 in sepsis in neonates, and explore the regulatory effects of miR-141 on inflammation in monocytes. This study used qRT-PCR to calculate the expression of miR-141 in the serum of septic neonates. The diagnostic values of procalcitonin (PCT) and serum miR-141 were evaluated by receiver operating characteristic (ROC) curves. The relationship between miR-141 and TLR4 was determined using luciferase reporter assay. An inflammation model was established using monocytes with lipopolysaccharide (LPS) treatment. ELISA assay was used to analyze the levels of pro-inflammatory cytokines. The expression of miR-141 in neonatal sepsis was significantly lower than healthy controls. ROC curves showed that miR-141 had diagnostic accuracy. LPS stimulation in monocytes led to a decrease in the expression of miR-141. A luciferase reporter assay proved that miR-141 targeted TLR4, and a negative correlation of miR-141 with TLR4 was found in septic neonates. ELISA results demonstrated that the overexpression of miR-141 inhibited LPS-induced inflammation in monocytes. In conclusion, serum decreased miR-141 expression served as a candidate diagnostic biomarker of neonatal sepsis. TLR4 is a target gene of miR-141, which may mediate the inhibitory effects of miR-141 overexpression on LPS-induced inflammation in monocytes. Therefore, miR-141 is expected to be a potential diagnostic biomarker and a therapeutic target in neonatal sepsis.


Subject(s)
Humans , Infant, Newborn , Sepsis , MicroRNAs , Neonatal Sepsis , Monocytes , Lipopolysaccharides , Toll-Like Receptor 4
6.
Autops. Case Rep ; 11: e2021271, 2021. graf
Article in English | LILACS | ID: biblio-1249007

ABSTRACT

Extremely low birth weight (ELBW) infants are at particularly high risk for infection due to an immature immune system, invasive procedures such as endotracheal intubation, intravascular catheterization, and other factors. Neonatal infections in this population are associated with a high mortality, poor growth, and neurodevelopmental outcomes. Pseudomonas aeruginosa (P. aeruginosa) infection is an uncommon but potentially devastating cause of pneumonia and sepsis in the ELBW population. P. aeruginosa is an important cause of healthcare-associated infections (HAI) or nosocomial infections. P. aeruginosa can perceive unfavorable environmental changes and orchestrate adaptations by developing plasmid-mediated and adaptive resistance to antibiotics. We describe an ELBW infant born at 26 weeks' gestation who succumbed at 13 days of life to P. aeruginosa infection. Some of the factors related to the pathogenesis and multidrug resistance are described.


Subject(s)
Humans , Male , Infant, Newborn , Pseudomonas aeruginosa , Bronchopneumonia , Infant, Low Birth Weight , Cross Infection , Neonatal Sepsis
7.
Rev. chil. pediatr ; 91(5): 749-753, oct. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144274

ABSTRACT

INTRODUCCIÓN: La malaria congénita (MC) es la infección por Plasmodium spp adquirida in útero o durante el parto y sus manifestaciones clínicas son inespecíficas. Puede causar enfermedad grave en la embaraza da y en el recién nacido. OBJETIVO: describir dos casos de MC causados por Plasmodium falciparum, diagnóstico diferencial de sepsis en recién nacidos de gestantes que hayan visitado o residan en áreas endémicas para malaria. CASOS CLÍNICOS: Neonatos de sexo femenino, nacidos en área no endémica para malaria, diagnosticados con sepsis neonatal y tratados con antibióticos sin respuesta clínica. Después de la primera semana de vida la gota gruesa identificó trofozoítos de Plasmodium falciparum y los neonatos recibieron tratamiento con quinina intravenosa con mejoría. Las madres de las recién nacidas tuvieron malaria en el embarazo, una de ellas recibió tratamiento y estaba asintomática y otra tenía malaria complicada al momento del parto. CONCLUSIONES: La MC puede causar enfermedad neonatal grave con manifestaciones clínicas inespecíficas y similares a la sepsis, el tratamiento oportuno disminuye el riesgo de malaria complicada. Es un diagnóstico diferencial en recién nacidos de mujeres con malaria durante el embarazo o gestantes que visiten o residan en áreas endémicas.


INTRODUCTION: Congenital malaria (CM) is a Plasmodium spp infection acquired in utero or during delivery with nonspecific clinical manifestations. Plasmodium falciparum can cause severe illness in pregnant wo men and newborns. OBJECTIVE: to describe two cases of CM caused by Plasmodium falciparum, di fferential diagnosis of sepsis in newborns of pregnant women who live in or have visited endemic malaria zones. CLINICAL CASES: Female neonates born in a non-endemic malaria area, diagnosed with neonatal sepsis and treated with antibiotics without clinical response. After the first week of life, the peripheral blood smear identified trophozoites of Plasmodium falciparum thus the newborns were treated with intravenous quinine, improving their condition. The mothers of the two newborns who had malaria in pregnancy, one of them received treatment and she was asymptomatic, and the other one had severe malaria at the time of delivery. CONCLUSIONS: CM can cause severe neonatal disease with non-specific, sepsis-like clinical manifestations in which early treatment decreases the risk of complicated malaria. It is a differential diagnosis in newborns of women with a history of malaria during pregnancy or pregnant women visiting or living in endemic malaria areas.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Young Adult , Malaria, Falciparum/congenital , Malaria, Falciparum/diagnosis , Pregnancy Complications, Parasitic/diagnosis , Pregnancy Complications, Parasitic/drug therapy , Neonatal Sepsis/diagnosis , Malaria, Falciparum/transmission , Infectious Disease Transmission, Vertical , Diagnosis, Differential , Neonatal Sepsis/parasitology , Antimalarials/therapeutic use
8.
Arch. argent. pediatr ; 118(4): 265-272, agosto 2020. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1118500

ABSTRACT

Introducción. El objetivo fue determinar la relación entre la concentración materna e infantil de vitamina D y la sepsis de aparición tardía. Población y métodos. En este estudio se incluyó a los bebés nacidos con ≥ 37 semanas de gestación hospitalizados con diagnóstico de sepsis de aparición tardía. Se comparó la concentración de vitamina D de los niños y sus madres del grupo del estudio y del de referencia. Resultados. El grupo del estudio incluyó a 46 pacientes con sepsis de aparición tardía nacidos a término y el grupo de referencia, 46 pacientes con hiperbilirrubinemia. La suplementación con vitamina D durante el embarazo fue menor en las madres del grupo del estudio que en el de referencia (p = 0,001). La concentración sérica de 25-hidroxivitamina D [25(OH)D] de los niños y las madres del grupo del estudio fue significativamente menor que la del grupo de referencia (p < 0,001). Se observó una correlación positiva entre la 25(OH)D en las madres y los niños de ambos grupos (r: 0,38; p < 0,001). El valor de corte para la 25(OH)D, que determina el riesgo de sepsis neonatal de aparición tardía, se estableció en 15,45 ng/ml (sensibilidad: 91,3 %; especificidad: 71,7 %; área bajo la curva: 0,824; p < 0,001). Conclusiones. La concentración de 25(OH)D fue inferior en los bebés nacidos a término con sepsis de aparición tardía y sus madres en comparación con el grupo de referencia. La correlación entre la concentración sérica de 25(OH)D de los niños y sus madres fue positiva.


Introduction. The objective was to determine the relationship between mother and infant vitamin D levels and late onset sepsis. Population and methods.Infants born ≥37 weeks of gestational age who were hospitalized with the diagnosis of late-onset sepsis were enrolled to this prospective case control study. VitaminD levels of the infants and their mothers in the study and a control group were compared. Results. Fourty six term patients with lateonset sepsis composed the study group, 46 patients with hyperbilirubinemia as the control group. Vitamin D supplementation during pregnancy was lower in mothers of study group compared to the control group (p = 0.001). Serum 25-hydroxyvitamin D levels of infants and mothers in the study group were significantly lower than the control group (p < 0.001). There was a positive correlation between 25-hydroxyvitaminD levels of mothers and infants in both groups (r: 0.38, p < 0.001). The best cut off value of 25-hydroxyvitamin D, which determines the risk of late-onset sepsis in neonates, was detected as 15.45 ng/ml (sensitivity: 91.3 %, specificity: 71.7 %, area under the curve: 0.824, p < 0.001). Conclusions.In this study, 25-hydroxyvitaminD levels were found to be lower in term infants with late-onset sepsis and among their mothers compared to the control group. Positive correlation was found between serum 25(OH)D levels of infants and their mothers. Key words: newborn infant, sepsis,


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Vitamin D , Neonatal Sepsis/diagnosis , Vitamin D Deficiency/complications , Intensive Care Units, Neonatal , Case-Control Studies , Neonatal Sepsis/prevention & control , Neonatal Sepsis/drug therapy , Mothers
9.
Article in Chinese | WPRIM | ID: wpr-879769

ABSTRACT

OBJECTIVE@#To study the clinical significance and cut-off value of white blood cell (WBC) count in the diagnosis of early-onset sepsis (EOS) in neonates.@*METHODS@#A retrospective analysis was performed on 306 neonates with EOS who were admitted from January 2019 to March 2020. A total of 580 children without infection who were admitted during the same period of time were enrolled as the control group. General status and WBC count were compared between the two groups. The diagnostic value of WBC count was analyzed based on the diagnostic and therapeutic protocol of neonatal sepsis in 2003 (referred to as the 2003 diagnostic and therapeutic protocol) and the expert consensus on the diagnosis and treatment of neonatal sepsis (2019 edition) (referred to as the 2019 expert consensus).@*RESULTS@#According to the two different diagnosis and treatment protocols, the statistical analysis showed that WBC count had a relatively positive rate (51.3% and 32.0% respectively) but a relatively high specificity (93.3% and 98.6% respectively). The receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve of WBC count in the 2003 diagnostic and therapeutic protocol was larger than that in the 2019 expert consensus (P<0.05).@*CONCLUSIONS@#The cut-off value of WBC ≥25×10


Subject(s)
C-Reactive Protein/analysis , Humans , Infant, Newborn , Leukocyte Count , Neonatal Sepsis/diagnosis , ROC Curve , Retrospective Studies
10.
Revista Digital de Postgrado ; 9(1): e192, 2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1053027

ABSTRACT

Objetivo: Evaluar la epidemiología de la sepsis neonatal en los recién nacidos atendidos en emergencia pediátrica del HUC del 1 de enero 2017 al 31 de diciembre del 2017. Métodos: estudio descriptivo, prospectivo, que incluyó a los recién nacidos con diagnóstico de sepsis neonatal. Se recolectaron datos como edad, sexo, lugar de nacimiento, lugar de procedencia, factores de riesgos, manifestaciones clínicas. Resultados: se incluyeron 14 pacientes con diagnóstico de sepsis neonatal. Grupo de edad más afectado: 15-21 días 50% (n=7), género más afectado: masculino 71,42% (n=10), lugar de nacimientos más frecuente Distrito Capital 57,15% (n=8), lugar de procedencia más frecuente estado Miranda 71,43% (n=10), Según tiempo de evolución, la más frecuente fue sepsis neonatal tardía 92,86% (n=13), los principales factores de riesgos identificados fueron: infección materna en el 3er trimestre 36,35% (n=8), prematuridad 29,42% (n=5), bajo peso al nacer 23,54% (n=4), procedimientos invasivos 37,50% (n=3), las manifestaciones clínicas más frecuentes fueron: fiebre, ictericia, palidez o aspecto séptico 7,89% (n=6), la incidencia de sepsis neonatal en el estudio fue 3.92 por 1000 nacidos vivos y 2,6% de casos atendidos con sepsis neonatal. Conclusión: epidemiológicamente la sepsis neonatal, es más frecuente en el grupo de edad de 15-21 días, sexo masculino, lugar de nacimiento Distrito Capital, procedencia estado Miranda, factores de riesgo más frecuentes infección materna en el 3er trimestre, prematuridad, bajo peso al nacer, procedimientos invasivos. Manifestaciones clínicas más frecuente fiebre, ictericia, palidez o aspecto séptico, incidencia de 3.92 por 1000 nacidos vivos y 2,6% de casos atendidos con sepsis neonatal(AU)


Objective: To evaluate the epidemiology of neonatal sepsis in newborns attended in pediatric emergency of the HUC from January 1, 2017 to December 31, 2017. Methods: a prospective, descriptive study that included newborns with a diagnosis of neonatal sepsis. Data were collected as age, sex, place of birth, place of origin, risk factors, clinical manifestations. Results: 14 patients with diagnosis of neonatal sepsis were included. Most affected age group: 15-21 days 50% (n = 7), most affected gender: male 71.42% (n = 10), most frequent place of births Capital District 57.15% (n = 8), Most frequent place of origin Miranda state 71.43% (n = 10), According to time of evolution, the most frequent was late neonatal sepsis 92.86% (n = 13), the main risk factors identified were: maternal infection in 3rd trimester 36.35% (n = 8), prematurity 29.42% (n = 5), low birth weight 23.54% (n = 4), invasive procedures 37.50% (n = 3), the most frequent clinical manifestations were: fever, jaundice, pallor or septic appearance 7.89% (n = 6), the incidence of neonatal sepsis in the study was 3.92 per 1000 live births and 2.6% of cases attended with neonatal sepsis. Conclusion: neonatal sepsis is epidemiologically more frequent in the age group of 15-21 days, male sex, place of birth, Capital District, Miranda state origin, most frequent risk factors maternal infection in the 3rd trimester, prematurity, low weight at birth, invasive procedures. Clinical manifestations more frequent fever, jaundice, pallor or septic appearance, incidence of 3.92 per 1000 live births and 2.6% of cases treated with neonatal sepsis(AU)


Subject(s)
Humans , Infant, Newborn , Bacterial Infections/drug therapy , Breast Feeding , Neonatal Sepsis/diagnosis , Neonatal Sepsis/epidemiology , Infant, Newborn , Infant, Premature/growth & development , Prospective Studies , Heart Defects, Congenital , Metabolic Diseases/drug therapy
11.
South Sudan med. j ; 13(3): 86-89, 2020.
Article in English | AIM | ID: biblio-1272133

ABSTRACT

Introduction: Neonatal sepsis is one of the most common causes of neonatal morbidity and mortality in developing countries.Objective: This study aimed to determine the prevalence and factors associated with neonatal sepsis among hospitalized new-borns at Ruvuma, southern Tanzania.Methods: A facility-based retrospective study was conducted at Songea Regional Referral hospital in Ruvuma, during August-October, 2018. A standardized questionnaire was used to collect demographic, obstetric and clinical information from medical case files of patients. Neonatal sepsis was diagnosed clinically. Data were analysed using SPSS version 24.0. Chi square test was used to assess relationship between outcome and exposure variables. Multivariate logistic regression was used to measure association after controlling for confounders, and P-values of <0.05 were statistically significant.Results: Medical case files of 263 neonates were reviewed. Of these, 131(49.8%) had sepsis. Factors associated with neonatal sepsis were prematurity (AOR=2.2; 95%CI. 1.3 ­ 3.6, p=0.002), age of more than a week (AOR=2.2; 95%CI. 1.0 ­ 4.6, p=0.04), intravenous cannulation after birth (AOR=6.3; 95%CI. 2.1 ­ 19.0, p=0.002), and resuscitation with nasal oxygen prongs (AOR=1.7; 95%CI. 1.1 ­ 2.9, p=0.02).Conclusions: Neonatal sepsis is relatively common among neonates in Ruvuma and is associated with maternal and health services related factors. The findings underscore the importance of routine assessment and close monitoring of neonates


Subject(s)
Child, Hospitalized , Infant, Newborn , Neonatal Sepsis/epidemiology , Neonatal Sepsis/mortality , Risk Factors , Tanzania
12.
Med. UIS ; 32(3): 35-47, Sep.-Dec. 2019. graf
Article in Spanish | LILACS | ID: biblio-1114975

ABSTRACT

Resumen La sepsis neonatal es una causa importante de morbilidad y mortalidad en recién nacidos a nivel mundial. Su diagnóstico es difícil por sus manifestaciones clínicas inespecíficas y la poca disponibilidad de métodos diagnósticos eficientes. En la fisiopatología de la sepsis se ha descrito una respuesta inmune excesiva o suprimida que puede conducir a desenlaces potencialmente fatales. Se ha estudiado la utilidad pronóstica, diagnóstica y de seguimiento de factores solubles que se alteran en la sepsis neonatal y se han agrupado bajo el término biomarcadores de sepsis neonatal. Aquí se describen los principios fisiopatológicos de la sepsis neonatal y las características de los biomarcadores más usados para su diagnóstico, además, se mencionan detalles de otros marcadores que también han sido estudiados recientemente. Actualmente, se recomienda el uso de un biomarcador temprano en combinación con uno tardío para lograr un mejor rendimiento, sin embargo, aún no se ha identificado un biomarcador ideal para la sepsis neonatal. MÉD.UIS.2019;32(3):35-47


Abstract Neonatal sepsis is a major cause of morbidity and mortality in newborns worldwide. Its diagnosis remains a challenge due to the nonspecific clinical findings and the lack of efficient diagnostic tools. In the physiopathology of neonatal sepsis, an excessive or suppressed immune response has been described, which can lead to potentially fatal conditions. The prognostic, diagnostic, and follow-up value of several soluble factors altered in neonatal sepsis has been studied. These have been grouped under the term neonatal sepsis biomarkers. Here, aspects of the physiopathology in neonatal sepsis and the characteristics of the most studied biomarkers used for neonatal sepsis diagnosis are described, also, details about other recently studied markers are mentioned. Currently, the use of an early-warning biomarker together with a late-warning biomarker is recommended to get higher diagnostic accuracy. However, a single ideal biomarker for neonatal sepsis has not been found yet. MÉD.UIS.2019;32(3):35-47


Subject(s)
Humans , Infant, Newborn , Neonatal Sepsis , Pediatrics , Signs and Symptoms , C-Reactive Protein , Infant, Newborn , Biomarkers , Morbidity , Mortality , Interleukin-6 , Sepsis , Diagnosis , Procalcitonin , Neonatology
13.
Rev. pediatr. electrón ; 16(3): 33-40, oct. 2019.
Article in Spanish | LILACS | ID: biblio-1046287

ABSTRACT

OBJETIVO: Analizar el uso de beta-lactámicos en sepsis neonatal tardía, en comparación con el tratamiento empírico actual con vancomicina, mediante la revisión de artículos científicos. METODOLOGÍA: Revisión temática en Bases LILACS y PubMed. La selección de los artículos se realizó mediante la lectura de título, abstract y texto completo. Criterios de búsqueda: Estudios en humanos, artículos por abstract y texto completo, en inglés y español, y de no más de 10 años. RESULTADOS: No hay relación en la duración ni en la mortalidad de la sepsis al utilizar un betalactámico, o al utilizar vancomicina. Además, cepas resistentes a beta-lactámico, respondieron bien al usar un beta-lactámico como terapia empírica inicial, sin la necesidad de recurrir a vancomicina, excepto en casos de no mejoría clínica. CONCLUSIONES: Beta-lactámicos pueden ser utilizados como terapia empírica inicial en sepsis neonatal tardía como alternativa al tratamiento actual con vancomicina, restringiendo el uso de vancomicina a casos de resistencia, o cuando no haya mejoría clínica del recién nacido que está utilizando un beta-lactámico como tratamiento.


OBJECTIVE: To analyze the use of beta-lactams in late- onset neonatal sepsis, compared with empirical treatment with vancomycin used currently, through the revision of scientific articles. METHODOLOGY: Thematic review in LILACS and PubMed. The articles were selected by reading the title, abstract and full text. Searching criteria: Human studies, articles by abstract and full text, in English and Spanish, and no more than 10 years since published. RESULTS: There is no relationship in duration or mortality in Sepsis when using beta-lactam, or using vancomycin. In addition, resistant strains to beta-lactam responded well in using betalactam as initial empirical therapy, without the need to resort to vancomycin, except in cases of non-clinical improvement. CONCLUSIONS: Beta-lactams may be used as initial empirical therapy in late-onset neonatal sepsis as an alternative to current vancomycin therapy, restricting the use of vancomycin to resistance cases, or when there is no clinical improvement in the neonate, who is using a beta-lactam as a treatment.


Subject(s)
Humans , Infant, Newborn , beta-Lactams/therapeutic use , Neonatal Sepsis/drug therapy , Vancomycin/therapeutic use , Anti-Bacterial Agents/therapeutic use
14.
Arch. argent. pediatr ; 117(5): 509-513, oct. 2019. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1054973

ABSTRACT

La utilización de probióticos en la población neonatal ha contribuido a una disminución de la morbilidad y mortalidad en esta población a través de la reducción en la incidencia de entidades como enterocolitis necrosante, infecciones asociadas al cuidado de la salud y sepsis neonatal. A pesar de los múltiples efectos beneficiosos descritos, este tipo de medicamentos debe ser administrado con precaución en los pacientes de alto riesgo, debido a que se han documentado reportes de casos de sepsis neonatal por Lactobacillus rhamnosus, Saccharomyces boulardii y Bifidobacterium, entre otros. Se presenta un caso atípico de sepsis neonatal por Lactobacillus reuteri en un recién nacido pretérmino extremo en una institución de alta complejidad en la ciudad de Bogotá D. C., Colombia. El desenlace, en nuestro caso, fue fatal, pese al manejo médico establecido.


The use of probiotics in the neonatal population has contributed to a decrease in morbidity and mortality in this population through the reduction in the incidence of entities such as necrotizing enterocolitis, infections associated with health care and neonatal sepsis. Despite the multiple beneficial effects described due to the use of probiotics, this type of medication should be administered with caution in high-risk patients because reports of cases of neonatal sepsis by Lactobacillus rhamnosus, Saccharomyces boulardii and Bifidobacterium, among others, have been documented. We present an atypical case of neonatal sepsis due to Lactobacillus reuteri in an extreme preterm newborn in a highly complex institution in the city of Bogotá D. C., Colombia. The outcome in our case was fatal despite the established medical management.


Subject(s)
Humans , Male , Infant, Newborn , Lactobacillus reuteri , Neonatal Sepsis , Pre-Eclampsia , Fatal Outcome , Probiotics/adverse effects , Infant, Extremely Premature
15.
Rev. ecuat. pediatr ; 20(1): 21-33, Agosto2019.
Article in Spanish | LILACS | ID: biblio-1010311

ABSTRACT

Antecedente: el diagnóstico de la sepsis neonatal se basa en parámetros clínicos y de laboratorio, siendo el hemocultivo el estándar de oro. El uso de biomarcadores ­como la procalcitonina, la proteína C reactiva y otros complementarios, como el conteo de leucocitos­ podría contribuir al diagnóstico temprano de la sepsis neonatal. Propósito: comparar el uso de la proteína C reactiva, la procalcitonina, el conteo de leucocitos y el hemocultivo entre los recién nacidos a término y pretérmino para la identificación de los biomarcadores de la sepsis neonatal. Materiales y métodos: este es un estudio multicéntrico, descriptivo, transversal y prospectivo de cohortes, desarrollado en el Hospital Pediátrico Baca Ortiz y en el Hospital Ginecológico Obstétrico Isidro Ayora. Se analizarán 204 casos de neonatos pretérmino y a término, con factores de riesgo y alta sospecha clínica de sepsis neonatal, que fueron admitidos en el periodo de septiembre a diciembre del 2018, en quienes se evaluaron los diagnósticos complementarios tanto al ingreso como a las 72 horas de admisión. Se tomaron las variables demográficas, de morbilidad, operativas y de laboratorio. Se aplicó la estadística descriptiva con medidas de tendencia central e inferencial (chi-cuadrado y test U de Mann Whitney). Se diseñaron curvas ROC (Receiver Operating Characteristic), estableciendo sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo para los complementarios diagnósticos en relación con el estándar de oro. Resultados: el conteo de leucocitos presenta una sensibilidad de 29 %-23 %, una especificidad de 92 %-92 %, un valor predictivo positivo de 56 %-50 %, un valor predictivo negativo de 79 %-78 %. El conteo de neutrófilos indica una sensibilidad de 24 %-21 %, una especificidad de 93 %-93 %, un valor predictivo positivo de 52 %-50 %, un valor predictivo negativo de 78 %-77 %; el conteo de plaquetas mostró una sensibilidad de 62-71 %, 78-77 %, 48-51 % y 86-89 %; una cuantificación de PCR indicó una sensibilidad de 87-79 %, una especificidad de 63-73 %, un valor predictivo positivo de 44-50 % y un valor predictivo negativo de 93-91 %; la cuantificación de procalcitonina presentó un sensibilidad de 73-54 %, una especificidad 61-84 %, un valor predictivo positivo de 39-53 % y un valor predictivo negativo de 87-84 %. En todos los casos la cuantificación se realizó entre las 24 y las 72 horas de vida.


Background: The diagnosis of neonatal sepsis is based on clinical and laboratory parameters, blood culture being the gold standard. The use of biomarkers such as procalcitonin and C-reactive protein and complementary tests such as leukocyte count could contribute to the early diagnosis of neonatal sepsis. Aim: To compare the use of C-reactive protein, procalcitonin, leukocyte count and blood culture between term and preterm infants for the identification of biomarkers of neonatal sepsis. Materials and Methods: This is a prospective, cross-sectional multicenter descriptive study of cohorts, donne at the Baca Ortiz Pediatric Hospital and Gynecological Obstetric Hospital Isidro Ayora. 204 cases of preterm and term neonates were analyzed, these neonates had risk factors and high clinical suspicion of neonatal sepsis and were admitted to the above mentioned hospitals in the period from September to December 2018, and who were evaluated at admission and at 72 hours of admission. Demographic, morbidity, operative and laboratory variables were taken. Descriptive statistics were applied with measures of central tendency, and inferential (Chi Square and Test U of Mann Whitney). ROC curves (Receiver Operating Characteristic) were designed, establishing sensitivity, specificity, positive predictive value, negative predictive value for complementary diagnoses in relation to the gold standard. Results: The leukocyte count has a sensitivity of 29 %, specificity 92 %, positive predictive value 56 %, negative predictive value 79 %, neutrophil count has a sensitivity of 24 %, specificity 93 %, positive predictive value of 52 %, negative predictive value 78 %, platelet count has a sensitivity of 62-71%, specificity 78 %, positive predictive value 48 %, negative predictive value 86 %, CRP measurement had a sensitivity 87 %, specificity 63 %, positive predictive value 39 %, negative predictive value 87 % and measurement of procalcitonin had a sensitivity 73 %, specificity 61 %, positive predictive value 39 %, negative predictive value 87 %. In all cases the measurements were done between 24 to 72 hours of life.


Subject(s)
Humans , Infant, Newborn , C-Reactive Protein , Neonatal Sepsis , Blood Culture , Procalcitonin , Leukocytes , Infant, Premature , Epidemiology, Descriptive , Term Birth
16.
Rev. chil. infectol ; 36(4): 433-441, ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1042659

ABSTRACT

Resumen Introducción: Las infecciones causadas por enterobacterias productoras de β-talactamasas de espectro extendido (EP-BLEE) tienen implicaciones sobre la morbilidad y mortalidad neonatal. Objetivo: Describir la prevalencia de EP-BLEE en sepsis neonatal y los factores asociados. Métodos: Estudio de cohorte prospectivo, desde agosto del 2016 a agosto del 2017. Se incluyeron recién nacidos (RNs) ingresados en el Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Mediante prueba de difusión de doble disco se indagó la presencia de EP-BLEE y su asociación con características clínicas y demográficas de los RNs. Resultados: Se estudiaron 1.501 RNs hospitalizados, con edad gestacional promedio de 36,3 semanas. Se diagnosticaron 196 eventos de sepsis neonatal, la etiología más frecuente fueron enterobacterias (45,5%); 88,8% demostraron resistencia a ampicilina y más de 42% a cefalosporinas de amplio espectro. El 22,9% presentó fenotipo BLEE positivo. Tener Apgar ≤ 7 a los cinco minutos de vida (OR 4,6; IC 95% 1,47-14,6) y edad gestacional < 37 semanas (OR 5,4; IC 95%1,04-27,7) incrementaron el riesgo. Conclusión: En las enterobacterias causantes de sepsis neonatal, 22,9% son EP-BLEE; la infección es más probable en pacientes con Apgar ≤ 7 a los cinco minutos de vida y en prematuros.


Background: Infections caused by extended-spectrum beta-lactamases enterobacteria (ESBL-EP) have implications for neonatal morbidity and mortality. Aim: To describe the prevalence of ESBL-EP in neonatal sepsis and associated factors. Methods: A prospective cohort study was conducted from August 2016 to August 2017; newborn babies (NB) hospitalized in the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" were included. The ESBL-EP were investigated by double-disk synergy test and its association with clinical and demographic characteristics of the NB. Results. A total of 1,501 hospitalized NB were studied, with an average gestational age of 36.3 weeks. They were diagnosed 196 neonatal sepsis events, the most frequent etiologies were enterobacteria (45.5%). Resistance to ampicilin was found in 88.8% and to broad spectrum cephalosporins in more than 42% of the strains; 22.9% of them were ESBL phenotype. Apgar ≤ 7 at five minutes of life (OR 4.6; 95% CI 1.47-14.6) and gestational age < 37 weeks (OR 5.4; 95% CI 1.04-27.) increase the risk. Conclusion: In enterobacteria that cause neonatal sepsis, 22.9% were EP-ESBL; infection was more likely in patients with Apgar ≤ 7 at five minutes of age and in preterm infants.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Adolescent , Adult , Middle Aged , Young Adult , beta-Lactamases/biosynthesis , Cross Infection/microbiology , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/microbiology , Neonatal Sepsis/microbiology , Anti-Bacterial Agents/pharmacology , Intensive Care Units, Neonatal , Microbial Sensitivity Tests , Prevalence , Prospective Studies , Risk Factors , Enterobacteriaceae/classification
17.
Arch. med ; 19(2): 320-330, 2019/07/30.
Article in Spanish | LILACS | ID: biblio-1023123

ABSTRACT

Objective: to determine the relationship and association of early sepsis with interleukin- 6 measured in umbilical blood, as well as gestational age and birth weight, prenatal history of the mother pathologies during pregnancy, in newborns at the Neonatology Service of Carlos Andrade Marín Hospital (Quito). Material and methods: epidemiological, observational, analytical, cross-sectional. 200 newborns were analyzed. IL-6 was determined by Elisa. Results: newborn mean gestational age 38.4±2 weeks, mean weight 2871±532.4 grams, cutoff point interleukin 6 ≤14pg/uL; male sex was 43.9%, female sex 56.1%; preeclampsia of the mother 22.4%, infection of the urinary tract during pregnancy 20.4%; vaginitis/vaginosis 19.4%; IL6 values ≤ 14 pg/uL in 63.3% of patients; IL6 values of >14 pg/uL 36.7%; relationship with sepsis in all, p<0.05; relationship of prenatal pre-maternity of the mother and neonatal sepsis, p<0.05; relationship between vaginitis/vaginosis of the mother with neonatal sepsis; p<0.05; OR: 38.88 IC95% (4.912-307.728); association between sepsis and risk factors, IL6, gestational age in weeks, weight, prenatal preeclampsia and urinary tract infection, vaginitis/vaginosis, p<0.05. Conclusion: it is concluded that there is a correlation of risk factors, such as gestational age in weeks, weight, prenatal preeclampsia, UTI prior to birth, vaginitis/vaginosis, and values of interleukin 6 ≤ 14 pg/uL. The mean gestational age was 38.4 weeks, and average weight 2871 grams in the newborns analyzed..(AU)


Objetivo: determinar la relación de sepsis temprana con interleucina 6 medida en sangre umbilical, así como la edad gestacional y el peso al nacer, antecedentes prenatales de patologías maternas durante el embarazo, en recién nacidos en el Servicio de Neonatología del Hospital Carlos Andrade Marín (Quito). Material y métodos: estudio epidemiológico, observacional, analítico, transversal. Se analizaron 200 recién nacidos. La IL-6 fue determinada por Elisa. Resultados: edad gestacional promedio del recién nacido 38.4±2 semanas, peso promedio 2871±532.4 gramos, punto de corte interleucina 6 ≤14pg/uL; el sexo masculino fue del 43,9%, el sexo femenino del 56,1%; preeclampsia de la madre 22.4%, infección del tracto urinario durante el embarazo 20.4%; vaginitis/vaginosis 19,4%; Valores promedio de IL6 ≤14 pg/uL en el 63,3% de los pacientes; valores de IL6 de> 14 pg/uL en 36.7% de pacientes; relación con sepsis en total, p<0.05; relación de la pre-maternidad prenatal de la madre y sepsis neonatal con p <0.05; relación entre vaginitis/vaginosis de la madre con sepsis neonatal con p<0.05; OR (verosimilitud): 38,88 IC95% (4.912-307.728); asociación entre sepsis y factores de riesgo, IL6, edad gestacional en semanas, peso, preeclampsia prenatal e infección del tracto urinario, vaginitis/vaginosis, p <0,05. Conclusión: se concluye que existe correlación de factores de riesgo como la edad gestacional en semanas, el peso, la preeclampsia prenatal, la infección de vías urinarias antes del nacimiento, la vaginitis/vaginosis y los valores de interleucina 6 ≤1 4 pg/uL. La edad gestacional media fue de 38,4 semanas y el peso promedio de 2871 gramos en los recién nacidos analizados..(AU)


Subject(s)
Female , Schools, Nursery , Risk Factors , Fetal Blood , Neonatal Sepsis
18.
Medicentro (Villa Clara) ; 23(2): 133-135, abr.-jun. 2019.
Article in Spanish | LILACS | ID: biblio-1040491

ABSTRACT

RESUMEN Se realizó este estudio en el servicio de Neonatología del Hospital Universitario Pediátrico José Luis Miranda, de Santa Clara, en el período de junio 2015 - mayo 2016. Se analizaron los aislamientos de microorganismos en los cultivos realizados a los neonatos hospitalizados, con el objetivo de investigar la prevalencia y sensibilidad de estos gérmenes. Se confirmaron 69 aislamientos, en los cuales predominaron los gérmenes grampositivos; el estafilococo prevaleció de forma significativa y ofreció resistencia creciente a cefazolina. Dentro de los gramnegativos, la escherichia coli resultó el microorganismo con mayor aislamiento, mientras que el acinetobacter se comportó resistente a las cefalosporinas.


ABSTRACT A study was carried out in the Neonatology service at "José Luis Miranda" Pediatric University Hospital, in Santa Clara, from June, 2015 to May, 2016. The isolations of microorganisms in the cultures performed on hospitalized neonates were analyzed with the aim of investigating the prevalence and sensitivity of these germs. Sixty-nine isolates were confirmed, in which the gram-positive ones predominated; staphylococcus prevailed significantly and offered a high resistance to cefazolin. Escherichia coli was the microorganism with the highest isolation among the gram-negative bacteria, while acinetobacter exhibited resistant to cephalosporins.


Subject(s)
Intensive Care Units, Neonatal , Escherichia coli/isolation & purification , Neonatal Sepsis
19.
Biosci. j. (Online) ; 35(2): 629-639, mar./apr. 2019. tab, ilus
Article in English | LILACS | ID: biblio-1048616

ABSTRACT

Neonatal sepsis is a clinical syndrome defined by systemic signs of infection in newborns accompanied by bacteremia. Can be responsible for serious consequences for the newborn child,characterized at the birth as early sepsis or late onset sepsis, with high rate of neonatal morbidity and mortality. Pathological agents such as Escherichia coli (E. coli), Streptococcus agalactiae (S. agalactiae), Ureaplasma urealyticum and Mycoplasma hominis are most often responsible for intrauterine infections. The objective of this study is to evaluate the factors of neonatal sepsis predisposition in pregnant women through histopathological examination and the apoptotic index of placental tissues and detect DNA of E. coli and S. agalactiae using the Polymerase Chain Reaction (PCR). Histopathological analyses were made and the apoptotic index was determined to verify the levels of possible inflammatory infiltrates and cell death. Placenta samples were collected from November 2013 to May 2014. After DNA extraction, a PCR was performed amplifying the target fragment from the conserved regions of the rpoB (beta-RNA polymerase) polymorphism of E. coli and the factor 1 of S. agalactiae. The apoptosis index was tested with Acridine Orange and the histological procedure with Hematoxylin-Eosin staining. Among 100 samples of placental tissues analyzed by PCR, 48 represented the control group and did not present a risk factor associated with neonatal sepsis, and 52 samples representing the study group had at least one risk factor. Among these 52 samples, 7 (13.4%) had a PCR positive for E. coli. No placenta samples showed a positive PCR for S. agalactiae. The quantification of the apoptotic index did not show statistical significances between the groups and no inflammatory infiltrates were observed. However, histological sections showed fibrinoid necrosis, infarct areas and areas of calcification in all samples. Therefore, the results allow to conclude that the seven patients of experimental group with positive PCR for E. coli had eminent risk factors of neonatal sepsis, and the infection of the urinary tract (UTI) is the main aggravating circumstance. The histopathological examination demonstrated that the risk factors caused significant alterations, producing fibrinoid necrosis and infarcted areas in the placenta, contrary to apoptotic index that didn't differ from the group with unprecedented risk


A sepse neonatal é uma síndrome clínica definida por sinais sistêmicos de infecção em recém-nascidos acompanhados de bacteremia. Pode ser responsável por sérias consequências para o recém-nascido, caracterizadas ao nascimento como sepse precoce ou sepse tardia, com alta taxa de morbidade emortalidade neonatal. Agentes patológicos como Escherichia coli (E. coli), Streptococcus agalactiae (S. agalactiae), Ureaplasma urealyticum e Mycoplasma hominis são mais frequentemente responsáveis por infecções intra-uterinas. O objetivo deste estudo é avaliar os fatores de predisposição da sepse neonatal em gestantes através do exame histopatológico e do índice apoptótico de tecidos placentários e detectar DNA de E. coli e S. agalactiae utilizando a reação em cadeia da polimerase (PCR). Análises histopatológicas foram realizadas e o índice apoptótico foi determinado para verificar os níveis de possíveis infiltrados inflamatórios e morte celular. Amostras de placenta foram coletadas de novembro de 2013 a maio de 2014. Após a extração de DNA, foi realizada uma PCR amplificando o fragmento alvo das regiões conservadas do polimorfismo rpoB (polimerase beta-RNA) de E. coli e o fator 1 de S. agalactiae. O índice de apoptose foi testado com alaranjado de acridina e o procedimento histológico com coloração de hematoxilina-eosina. Entre 100 amostras de tecidos placentários analisados por PCR, 48 representaram o grupo controle e não apresentaram fator de risco associado à sepse neonatal, e 52 amostras representativas do grupo de estudo apresentaram pelo menos um fator de risco. Entre essas 52 amostras, 7 (13,4%) apresentaram PCR positivo para E. coli. Nenhuma amostra de placenta foi positivo para S. agalactiae na PCR. A quantificação do índice apoptótico não mostrou significância estatística entre os grupos e não foram encontrados infiltrados inflamatórios. No entanto, cortes histológicos mostraram necrose fibrinóide, áreas de infarto e áreas de calcificação em todas as amostras. Portanto, os resultados permitem concluir que as sete pacientes do grupo experimental com PCR positivo para E. coliapresentavam fatores de risco eminentes de sepse neonatal, sendo a infecção do trato urinário (ITU), o principal agravante. O exame histopatológico demonstrou que os fatores de risco causaram alterações significativas, produzindo necrose fibrinóide e áreas infartadas na placenta, ao contrário o índice apoptótico que não diferiu do grupo sem precedentes de risco.


Subject(s)
Placenta , Bacteremia , Escherichia coli , Neonatal Sepsis , Streptococcus agalactiae , Polymerase Chain Reaction
20.
Rev. bras. anal. clin ; 51(1): 46-51, 30/03/2019. tab
Article in Portuguese | LILACS | ID: biblio-1008203

ABSTRACT

Objetivo: Determinar a prevalência de microrganismos e o perfil de sensibilidade antimicrobiana em hemoculturas positivas de pacientes com infecção de corrente sanguínea na Unidade de Terapia Intensiva neonatal de um hospital no Nordeste brasileiro. Métodos: Estudo transversal, retrospectivo, com descrição quantitativa dos resultados de hemoculturas de neonatos admitidos na unidade terapia intensiva neonatal de um hospital do Nordeste brasileiro. Resultados: A sepse neonatal teve como principal etiologia bactérias Gram-positivas, responsáveis por 73,1% das culturas positivas, sendo o Staphylococcus Coagulase-negativa o principal agente, enquanto que 21,5% se deram por um agente Gram-negativo. As bactérias Gram-positivas apresentaram boa sensibilidade ao linezolida e à vancomicina e a maioria das Gram-negativas foi sensível a colistina, meropenem e imipenem. Todos os isolados de Staphylococcus coagulase negativa foram sensíveis ao linezolida, à vancomicina e à tigeciclina. Conclusão: O conhecimento das características relacionadas à sensibilidade e resistência antimicrobiana é fundamental para uma melhor abordagem ao paciente com sepse neonatal, promovendo um manejo mais direcionado que possibilita uma recuperação mais rápida do recém-nascido. O conhecimento adquirido com esse estudo possibilitará um tratamento mais eficiente em cada caso, com base no quadro apresentado pelo paciente e as características do agente causador.


Objective: To determine the prevalence of microorganisms and the antimicrobial sensitivity profile in positive blood cultures of patients with bloodstream infection in the neonatal Intensive Care Unit of a hospital in the Brazilian Northeast. Methods: Cross-sectional, retrospective study with quantitative description of hemoculture results of neonates admitted to the neonatal intensive care unit of a Brazilian Northeast hospital. Results: Neonatal sepsis had as its main etiology Gram-positive bacteria responsible for 73.1% of the positive cultures, with coagulase-negative Staphylococcus being the main agent, while 21.5% were due to a Gramnegative agent. Gram-positive bacteria showed good sensitivity to linezolid and vancomycin and most Gram-negative strains were susceptible to colistin, meropenem and imipenem. All coagulase-negative Staphylococcus isolates were sensitive to linezolid, vancomycin and tigecycline. Conclusion: Knowledge of the characteristics related toantimicrobial susceptibility and resistance is fundamental for a better approach to the patient with neonatal sepsis, promoting a more targeted management that allows a faster recovery of the newborn. The knowledge gained from this study will allow a more efficient treatment in each case, based on the patient's presentation and the characteristics of the causative agent


Subject(s)
Drug Resistance, Microbial , Intensive Care Units, Neonatal , Microbial Sensitivity Tests , Neonatal Sepsis , Blood Culture
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