Abstract

GENES, Larissa et al. Neonatal Sepsis in Very-Low Birth-Weight Newborns over an 11 Year Period. Pediatr. (Asunción) [online]. 2013, vol.40, n.2, pp.145-154. ISSN 1683-9803.

Introduction: Neonatal Intensive-Care Units (NICUs) receive patients with a wide variety of risk factors, which combined with increasing survival of premature infants, generate higher incidences of hospital infections. Objective: To determine the incidence, mortality and etiology of early- and late-onset neonatal sepsis in very-low birth-weight (VLBW) newborns at the Neonatology Department of the Hospital de Clinicas of Asuncion Paraguay from 2001 to 2011. Methodology: We conducted a retrospective, observational, and descriptive study that included 364 newborns with birth weights of 500-1500 grams seen at our NICU between January 2001 and December 2011. Results: Of 364 VLBW newborns seen at the NICU, 110 died and 254 were discharged alive; a survival rate of 69.7%.  Early-onset sepsis occurred in 14 (3.8%), and mortality among them was 64.3%. In 123 cases (33.8%) of a first episode of late-onset sepsis, 34 (27.6%) died. A second episode of sepsis occurred in 43 newborns, of whom 11 (25.6%) died, and a third episode occurred in 10 newborns, with 1 (10%) dying. The greatest mortality (50%) occurred in the weight group of 500-750 grams in the first episode of late-onset sepsis. In early-onset sepsis, Group B Streptococci were isolated in 35.7% of cases. In late-onset sepses, coagulase-negative staphylococci were isolated in 56.1%, followed by Gram-negative bacilli in 26.8%, Staphylococcus aureus in 12.2%, and fungal infections in 3.3%. Rates of late-onset sepses were similar over the 11-year period, although highest in 2009, appearing in 22 of 43 patients (41.5%), with an overall reduction in mortality due to sepsis with peak rates in 2001: 80%, 2005: 50%, and 2010: 40%. Conclusions: Early-onset sepsis shows low rates of incidence in VLBW newborns, but high mortality, and the rate of late-onset sepsis is high, with similar rates over the 11-year period.

Keywords : Sepsis in newborns; early-onset neonatal sepsis; late-onset neonatal sepsis; very low birth weight; Neonatal Intensive Care Units.

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