scholarly journals Prognostic Factors of Early Neonatal Sepsis in the City of Cartagena Colombia

2018 ◽  
Vol 10 (12) ◽  
pp. 30 ◽  
Author(s):  
Jaime Lorduy Gómez ◽  
Stephanye Carrillo González ◽  
Ruby Elena Muñoz Baldiris ◽  
Anderson Díaz-Pérez ◽  
Iris Perez

INTRODUCTION: The obstetirc or noenatal risk factors, are in many cases the major evidence to define and forecast of an early neonatal sepsis, considering that a newborn that has lived less tan 72 hours presents unspecified clinical manifestations and the diagnostic exams utilize infectious and inflammatory markers, with there being very litttle scientific evidence to support and establish an early diagnosis. Objective: Associate the obstetric and neonatal risk factors with the presence of early sepsis in Cartagena. MATERIALS & METHODS: A retrospective study of cases and controls was conducted. The sample consisted of 183 cases and 366 controls, including pacients who met simultaneously inclusion and exclusion criteria. A bivariated analysis and a multivariated model of regression logistics were used. RESULTS: Among the associtated variables and early sepsis in which it was able to define the risk that is found when there is a premature membrane rupture > 18 hours (OR 9,57 IC 95% 4,12-22,26), premature newborn (OR 8,19 IC 95% 3,66-18,3), the presence of maternal fever (OR 6,49 IC 95% 3,43-12,3), marital status (OR 5,89 IC 95% 3,42-10,15) and level of education (OR 4,80 IC 95% 2,63-8,77). CONCLUSIONS: The mechanisms of fetal evaluation and maternal prophylaxis should be prioritized in the cases of pregnant women that present a premature membrane rupture >18 hours, and have kids who were born premature and living in couple with a low level of education.

2020 ◽  
Vol 20 (4) ◽  
pp. 1646-54
Author(s):  
Peter Thomas Cartledge ◽  
Fidel Shofel Ruzibuka ◽  
Florent Rutagarama ◽  
Samuel Rutare ◽  
Tanya Rogo

Introduction: There is limited published data on antibiotic use in neonatal units in resource-poor settings. Objectives: This study sought to describe antibiotic prescribing practices in three neonatology units in Kigali, Rwanda. Methods: A multi-center, cross-sectional study conducted in two tertiary and one urban district hospital in Kigali, Rwan- da. Participants were neonates admitted in neonatology who received a course of antibiotics during their admission. Data collected included risk factors for neonatal sepsis, clinical signs, symptoms, investigations for neonatal sepsis, antibiotics prescribed, and the number of deaths in the included cohort. Results: 126 neonates were enrolled with 42 from each site. Prematurity (38%) followed by membrane rupture more than 18 hours (25%) were the main risk factors for neonatal sepsis. Ampicillin and Gentamicin (85%) were the most commonly used first-line antibiotics for suspected neonatal sepsis. Most neonates (87%) did not receive a second-line antibiotic. Cefotaxime (11%), was the most commonly used second-line antibiotic. The median duration of antibiotic use was four days in all sur- viving neonates (m=113). In neonates with negative blood culture and normal C-reactive protein (CRP), the median duration of antibiotics was 3.5 days; and for neonates, with positive blood cultures, the median duration was 11 days. Thirteen infants died (10%) at all three sites, with no significant difference between the sites. Conclusion: The median antibiotic duration for neonates with normal lab results exceeded the recommended duration mandated by the national neonatal protocol. We recommend the development of antibiotic stewardship programs in neo- natal units in Rwanda to prevent the adverse effects which may be caused by inappropriate or excessive use of antibiotics. Keywords: (MeSH): Antimicrobial stewardship; anti-bacterial agents; neonatal sepsis; sepsis; infant mortality; neonatal intensive care units; Africa; Rwanda.


2019 ◽  
Vol 26 (12) ◽  
pp. 2044-2047
Author(s):  
Faraz Ahmed ◽  
Mohsin Ali ◽  
Hussan Ali Sarwar ◽  
Miqdad Haider ◽  
Muhammad Bilal Safdar ◽  
...  

One of the major and important but preventable causes of neonatal morbidity and mortality is Neonatal sepsis. Objectives: To determine the frequency of maternal risk factors in diagnosed cases of early neonatal sepsis. Study Design: Descriptive cross sectional study. Setting: Nursery, Department of Children Hospital and the institute of child health, Lahore. Period: 15-01-2016 to 15-07-2016. Material and Methods: After approval from hospital ethical committee, according to inclusion and exclusion criteria, 250 patients were enrolled in the study from nursery department of children hospital, Lahore. Maternal risk factors i.e. PROM, meconium stained liquor and preterm delivery were recorded along with the demographic information of each case. Results: In our study, out of 250 cases, cases between 1-2 days were 64.8% (n=162) while cases between 3 days of life were 35.2% (n=88), mean+sd was resulted as 2.17+0.69 days. Frequency of maternal risk factors in diagnosed cases of early neonatal sepsis was turned out as 64.8% (n=162) PROM, 29.6% (n=74) meconium stained liquor and preterm delivery was resulted in 21.2% (n=53). Conclusion: The leading maternal risk factor is PROM followed by meconium stained liquor and preterm delivery in diagnosed cases of early neonatal sepsis.


Author(s):  
Tariq Homoud Althagafi ◽  
Mona Abdullah Alharbi ◽  
Ashjan Nasser Bamarhool ◽  
Zahra Dheya Almajed ◽  
Leen Hani Natto ◽  
...  

Neonatal sepsis is a systemic disease caused by bacterial organisms, viral infections, or fungus that causes hemodynamic abnormalities and other clinical symptoms resulting in severe complications and may progress into mortality. Parturition can be used to diagnose organisms caused by the premature onset of sepsis in some cases, but only after an average of three days of life. Clinical manifestations of infection may also diagnose the organisms caused by the early onset of sepsis. Late sepsis can refer to any incident of sepsis from delivery to discharge in high-risk newborns, and the majority of them have been hospitalized for a lengthy period. Late-onset Guillain-Barré syndrome infections generally refer to the infections that occur between one week and up to three months post-labor. The precise load fraction for newborn sepsis varies by context, with differing load estimations between nations with varying lead levels. With the diversity of treatments utilized, explaining the degree of obstetric palsy is crucial and complicated. When comparing birthing sepsis rates, it is critical to understand if a tiny figure represents a total birth rate or another rate, such as a hospital admission number. As stated, it is critical to evaluate if population estimates based on the numbers of neonatal sepsis episodes have been recorded. This article aims to review the literature regarding neonatal sepsis from different aspects including, the etiology, risk factors, and different types and onset of neonatal sepsis.


2020 ◽  
Vol 11 (2.ESP) ◽  
Author(s):  
Katiane Da Silva Mendonça ◽  
Daíse Tavares Da Silva ◽  
Hallana Laisa De Lima Dantas ◽  
Keila Cristina Pereira do Nascimento Oliveira ◽  
Viviane Vanessa Rodrigues da Silva Santana

Objetivos: Descrever as evidências científicas que abordem os fatores de riscos associados à infecção por COVID-19 em indivíduos adultos jovens. Método: Trata-se de uma revisão integrativa da literatura em seis etapas, com uso do método PICO e Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Utilizou-se os níveis de evidência de Oxford para classificação dos artigos. Resultados: Dos 42 artigos encontrados, sete atenderam aos critérios de inclusão e exclusão. Todos os estudos são publicações de 2020. Observou-se que as doenças crônicas são apresentadas como principais fatores de risco para o COVID-19, apenas dois artigos apresentaram características relacionadas aos casos de mortes e apontaram condições subjacentes como agravantes para o novo coronavírus. Os estudos também apontaram a população jovem como a mais acometida pela doença associado a apresentação de sintomas leves como tosse, febre e fadiga, com baixa taxa de mortalidade em comparação ao grupo de risco.  Conclusão: Dentre os fatores de risco mais evidentes neste estudo pode-se ressaltar doenças cardiovasculares como a hipertensão, diabetes e tabagismo, apontandotambém uma maior prevalência de casos em indivíduos de sexo masculino. Descritores: Adulto Jovem; Coronavirus; Fatores de Risco; Morbidade.RISK FACTORS FOR THE WORSENING OF COVID-19 IN YOUNG INDIVIDUALSObjective: To describe the scientific evidence that addresses the risk factors associated with COVID-19 infection in young adult individuals. Method: This is an integrative review of the literature in six steps, using the PICO method and Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The Oxford levels of evidence were used to classify articles. Results: Of the 42 articles found, seven met the inclusion and exclusion criteria. All studies are publications from 2020. It was observed that chronic diseases are presented as the main risk factors for COVID-19, only two articles presented characteristics related to cases of death and pointed out underlying conditions as aggravating for the new coronavirus. The studies also pointed out the young population as the most affected by the disease associated with the presentation of mild symptoms such as cough, fever and fatigue, with a low mortality rate compared to the risk group. Conclusion: Among the most evident risk factors in this study, cardiovascular diseases such as hypertension, diabetes and smoking can be highlighted, also pointing to a higher prevalence of cases in male individuals.Descriptors: Young Adult; Coronavirus; Risk Factors; Morbidity.FACTORES DE RIESGO PARA EL EMPEORAMIENTO DE COVID-19 EN INDIVIDUOS JÓVENESObjetivos: Describir la evidencia científica que aborda los factores de riesgo asociados con la infección por COVID-19 en individuos adultos jóvenes. Método: Esta es una revisión integradora de la literatura en seis pasos, utilizando el método PICO y los elementos de informes preferidos para revisiones sistemáticas y metaanálisis. Los niveles de evidencia de Oxford se utilizaron para clasificar los artículos. Resultados: De los 42 artículos encontrados, siete cumplieron los criterios de inclusión y exclusión. Todos los estudios son publicaciones de 2020. Se observó que las enfermedades crónicas se presentan como los principales factores de riesgo para COVID-19, solo dos artículos presentaron características relacionadas con casos de muerte y señalaron condiciones subyacentes como agravantes para el nuevo coronavirus. Los estudios también señalaron a la población joven como la más afectada por la enfermedad asociada con la presentación de síntomas leves como tos, fiebre y fatiga, con una baja tasa de mortalidad en comparación con el grupo de riesgo. Conclusión: Entre los factores de riesgo más evidentes en este estudio, se pueden destacar las enfermedades cardiovasculares como la hipertensión, la diabetes y el tabaquismo, lo que también apunta a una mayor prevalencia de casos en hombres.Descriptores: Adulto Joven; Coronavirus; Factores de Riesgo; Morbilidad.


2006 ◽  
Vol 274 (4) ◽  
pp. 198-202 ◽  
Author(s):  
Shimrit Yaniv Salem ◽  
Eyal Sheiner ◽  
Ehud Zmora ◽  
Hillel Vardi ◽  
Ilana Shoham-Vardi ◽  
...  

2020 ◽  
Author(s):  
Marjan Salahi ◽  
Abdolkarim Ghadimi Moghadam ◽  
Ali Mousavizadeh ◽  
Masoud Marashifard ◽  
Seyed Jabar Taghavi ◽  
...  

Abstract Background: Neonatal sepsis is a serious worldwide problem causing significant rates of mortality and morbidity in newborns, especially in cases with delayed infection diagnosis and management. The present study aimed to evaluate the bacteriological profiles, antibiotic susceptibility patterns, risk factors, clinical manifestations, and laboratory findings in neonatal sepsis in southwest of Iran. Methods: In this descriptive-analytic study, 342 neonates with suspected sepsis admitted to the neonatal ward and NICU were included. Using standard protocols, blood samples were transported to the BACTEC blood culture system. Then, conventional biochemical tests were used for the identification of bacterial genera and species. The bacterial antimicrobial susceptibility patterns were determined usingagardisk diffusion method according to the CLSI guidelines. Demographic data, clinical findings, risk factors, mortality rates, and laboratory parameters were collected for each patient. Results: Forty-three (12.6%) cases were culture-positive, among whichCoNS, Staphylococcus aureus, Escherichia coli, Acinetobacter and Beta hemolytic streptococcus were the most prevalent. The prevalence of early-onset sepsis and late-onset sepsis were 53.5% and 46.5%, respectively. Significant differences between prematurity, very low birth weight, and invasive procedures were observedbetween neonates with and without sepsis. Teicoplanin and vancomycin were the most efficient antibiotics against Gram-positive bacteria, while amikacinwas more efficient against Gram-negative bacteria. Conclusion: Risk factors such as prematurity, abnormal birth weight, anemia, leukopenia, prolonged hospitalization, and invasive processes and cesarean section, can increase the incidence of neonatal sepsis.


Author(s):  
M.M. Kiselyova ◽  
◽  
O.V. Potsiurko ◽  
A.V. Komar ◽  
N.V. Kamut ◽  
...  

Neonatal sepsis is a significant cause of mortality among newborns, especially in low and middle income countries with poor economic development. It is important to start the appropriate treatment as soon as possible, as this prevents most deaths from sepsis and reduces the occurrence of residual neurological lesions due to septic meningitis. The article provides an overview of modern literature data on the principles of diagnosis of early neonatal sepsis; mentions the main etiological factors and ways of infection by potential pathogens. Diagnostic criteria for early neonatal sepsis have been analyzed and have been classified as doubt-ful or credible. An important role is given to the assessment of potential risk factors for the development of the septic process, including data on history of pregnancy and childbirth, clinical and laboratory indicators of the baby after birth. The nonspecificity of most clinical signs of sepsis and their comparison with clinical manifestations in meningitis was carried out. The importance of the bacteriological method of detecting the pathogen in the blood, urine and cerebrospinal fluid was analyzed, which remains the «gold» standard diagnosis of neonatal sepsis, and the method of multiplex polymerase chain reaction. There is a need to detect sepsis through visual examination, such as chest radiography, computed tomography, magnetic resonance imaging and ltrasonography of the head. The diagnostic value of indicators is described with the complete blood cell count and differential, including some of its components, and markers of inflammatory process, especially the immature-to-total (I/T) neutrophil ratio, C-reactive protein, procalcitonin. The article mentions a method of determining the concentration of immunoglobulin M in the serum, the elevated level of which indicates intrauterine infection. The diagnostic value of glutathione is considered, which is a marker of the functioning of the immune system. Emphasis is placed on the expediency of using Kaiser Permanente calculator to detect signs of sepsis in the first days of a newborn's life and the choice of optimal tactics management in such patients. No conflict of interest was declared by the authors. Key words: sepsis, newborn, diagnosis of infection, neonatal.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 166-166
Author(s):  
Kenneth M. Boyer ◽  
Samuel P. Gotoff

Wiswell et al1 assert that "if lumbar punctures (LPs) are omitted as part of the early neonatal sepsis evaluation, the diagnosis of bacterial meningitis occasionally will be delayed or missed completely." They call into question a study from our institution as well as several others2-5 that have recently concluded that cerebrospinal fluid (CSF) examination is not indicated in asymptomatic neonates with antepartum risk factors for infection." We would like to raise for discussion the semantics of Dr Wiswell's assertion and the data upon which it is based.


1997 ◽  
Vol 31 (7-8) ◽  
pp. 897-906 ◽  
Author(s):  
Beth A. Logsdon ◽  
Daniel T. Casto

OBJECTIVE: To review the epidemiology of group B Streptococcus (GBS) infection, risk factors for infection, and clinical manifestations of disease in the neonate, as well as the role of chemoprophylaxis and immunoprophylaxis in prevention of GBS disease and current recommendations for prevention. DATA SOURCES AND STUDY SELECTION: MEDLINE searches (1976–1997) of the English-language literature. DATA SYNTHESIS: Despite clinical advances in health care in the past two decades, GBS remains a leading cause of serious neonatal infection. Most early-onset GBS infections can be prevented through the use of intrapartum antimicrobial chemoprophylaxis. Preventing GBS infection in neonates is more cost-effective than treating GBS infections, and implementing prevention programs can reduce morbidity and mortality resulting from GBS disease. Many proposals have been made regarding prevention strategies; however, they have not been implemented widely and consistently in the US. To coordinate both pediatric and obstetric supported strategies, the Centers for Disease Control and Prevention (CDC) recently published recommendations for prevention of neonatal GBS disease through two possible strategies. In the first strategy, intrapartum antibiotic chemoprophylaxis should be offered to all women identified by prenatal culture as colonized and those who develop premature membrane rupture or onset of labor at less than 37 weeks gestation. The second strategy involves administration of intrapartum antibiotics to all women who develop one or more risk factors at the time of membrane rupture or onset of labor. CONCLUSIONS: GBS is difficult to eradicate, causing many women to be colonized with the organism during pregnancy and labor, thereby infecting their infant. Prevention strategies have been published for more than 10 years without successful implementation. Although optimal prevention management has not been defined, following one of two strategies recommended by the CDC can prevent the majority of GBS infections in neonates.


2018 ◽  
Vol 47 (1) ◽  
pp. 44 ◽  
Author(s):  
K S Y Perera ◽  
M Weerasekera ◽  
U D T M Weerasinghe

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