Análisis de la incidencia y factores de riesgo asociados a sepsis neonatal temprana
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Químicas
Resumen
La sepsis neonatal es una situación clínica derivada de la invasión y proliferación de microorganismos en el torrente sanguíneo del recién nacido (RN), que se manifiesta dentro de los primeros 28 días de vida, en Ecuador, según las estadísticas del INEC del año 2013 la sepsis bacteriana del recién nacido es la séptima causa de mortalidad en la población infantil.
En México, en el Hospital Civil de Guadalajara “Dr. Juan I Menchaca” (HCGJIM) se realizó el estudio de sepsis neonatal temprana en pacientes recién nacidos, el mismo que tenía por objeto describir la epidemiología de la SNT en un hospital público, al ser este estudio de cohorte prospectivo permitió analizar muestras de sangre y líquido cefalorraquídeo (LCR) obtenidos durante las primeras 72 horas de vida de aquellos pacientes con más de una manifestación clínica sugestiva de sepsis, pruebas de laboratorio anormales y a los RN con antecedentes maternos de infección de vías urinarias, corioamnionitis, fiebre y ruptura prematura de membranas mayor a 18h; para luego ser inoculadas en frascos de hemocultivo, agar sangre y McConkey, aislar la bacterias e identificar su género y especie.
De los 14207 pacientes analizados, 1550 fueron hospitalizados y se realizó las pruebas diagnósticas para SNT a 602 neonatos de los cuales 67 presentaron SNT lo que representa una incidencia del 4.7 eventos por cada 1000 RN nacidos vivos, la letalidad de SNT fue de 9% correspondiente a 6 neonatos, el 72% de bacterias aisladas corresponden a bacilos gram negativos y los principales factores de riesgo asociados a SNT fueron: edad materna menor a
15 años, ruptura prematura de membranas mayor a 18 horas, fiebre materna, peso al nacimiento menor a 2500g y edad gestacional menor a 37 semanas.
Neonatal sepsis is a clinical situation resulting from the invasion and proliferation of microorganisms in the bloodstream of the newborn (NB), which is manifested within the first 28 days of life, in Ecuador, according to statistics from INEC 2013 the bacterial sepsis of newborn is the seventh leading cause of mortality in children. In Mexico, in the Hospital Civil de Guadalajara “Dr. Juan I Menchaca” (HCGJIM) a neonatal sepsis study was conducted in newborn patients, which has as objective to describe the epidemiology of the SNT in a public hospital, being this study of prospective cohort allowed us to analyze blood samples and cerebrospinal fluid (CSF) obtained during the first 72 hours of life for those patients with more than one suggestive clinical manifestation of sepsis, irregular laboratory tests and infants with maternal history of urinary tract infection, chorioamnionitis, fever and premature rupture of membranes longer than 18h; then they would be inoculated into blood culture bottles, blood agar and McConkey, isolate the bacteria and identify their type and species. Among the 14207 analyzed patients, 1550 were hospitalized and diagnostic tests were performed for SNT 602 neonates of which 67 presented NTS representing an incidence of 4.7 events per 1000 NB live births, the lethality of NTS was 9% that correspond to 6 infants, the 72% of isolated bacterias correspond to gram-negative bacilli and the major associated risk factors with NTS were: maternal age less than 15 years, premature rupture of membranes longer than 18 hours, maternal fever, weight birth less than 2500g and gestational age less than 37 weeks.
Neonatal sepsis is a clinical situation resulting from the invasion and proliferation of microorganisms in the bloodstream of the newborn (NB), which is manifested within the first 28 days of life, in Ecuador, according to statistics from INEC 2013 the bacterial sepsis of newborn is the seventh leading cause of mortality in children. In Mexico, in the Hospital Civil de Guadalajara “Dr. Juan I Menchaca” (HCGJIM) a neonatal sepsis study was conducted in newborn patients, which has as objective to describe the epidemiology of the SNT in a public hospital, being this study of prospective cohort allowed us to analyze blood samples and cerebrospinal fluid (CSF) obtained during the first 72 hours of life for those patients with more than one suggestive clinical manifestation of sepsis, irregular laboratory tests and infants with maternal history of urinary tract infection, chorioamnionitis, fever and premature rupture of membranes longer than 18h; then they would be inoculated into blood culture bottles, blood agar and McConkey, isolate the bacteria and identify their type and species. Among the 14207 analyzed patients, 1550 were hospitalized and diagnostic tests were performed for SNT 602 neonates of which 67 presented NTS representing an incidence of 4.7 events per 1000 NB live births, the lethality of NTS was 9% that correspond to 6 infants, the 72% of isolated bacterias correspond to gram-negative bacilli and the major associated risk factors with NTS were: maternal age less than 15 years, premature rupture of membranes longer than 18 hours, maternal fever, weight birth less than 2500g and gestational age less than 37 weeks.
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SEPSIS NEONATAL, MICROORGANISMOS, CORIOAMNIONITIS, LÍQUIDO CEFALORRAQUÍDEO, RUPTURA PREMATURA DE MEMBRANAS