Análise clínica e laboratorial da sepse com hemocultura positiva em recém-nascidos internados em Unidade de Terapia Intensiva Neonatal durante 5 anos
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Data
2007-06-22
Autores
Silva, Geraldo Henrique Soares da [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Sepse é importante causa de morbidade e mortalidade em recém-nascidos, principalmente os prematuros. O objetivo deste estudo foi determinar a incidência e a mortalidade da sepse precoce e tardia com hemocultura positiva em recém-nascidos internados na Unidade de Terapia Intensiva Neonatal durante cinco anos e comparar dados clínicos e laboratoriais da sepse precoce e tardia e de acordo com os agentes etiológicos. Métodos: Estudo retrospectivo, realizado na Unidade de Terapia Intensiva Neonatal em recém-nascidos que apresentaram hemocultura positiva durante 1999 a 2003. Foram excluídos recém-nascidos que apresentaram crescimento de mais de um agente na mesma hemocultura ou o crescimento de agentes contaminantes sem correlação clínica. Recémnascidos foram comparados entre si na sepse precoce x sepse tardia e de acordo com os agentes etiológicos: Gram-positivos x Gram-negativos x Fungos. Variáveis estudadas: incidência e mortalidade; clínicas (peso de nascimento, idade gestacional, gênero, fatores de risco para sepse precoce e para sepse tardia); laboratoriais (hemograma completo, proteína C reativa, agentes em hemocultura). Análise estatística: Teste t de Student para variáveis paramétricas, Qui-quadrado para não paramétricas e ANOVA, com significância em 5%. A incidência de sepse com hemocultura positiva foi de 11% sendo de 1,5% de sepse precoce e 9,5% de sepse tardia. A mortalidade foi de 29,5% sendo maior na sepse precoce do que na sepse tardia (34% x 25%). Prematuridade e baixo peso foram as principais características clínicas dos recém-nascidos sépticos. A idade gestacional e o peso de nascimento foram menores na sepse tardia. índices leucocitários foram significativamente maiores na sepse precoce. A rotura prematura de membranas e o uso de antibioticoterapia prévia foram os principais fatores de risco na sepse precoce...
Sepsis is an important cause of neonatal morbidity and mortality , specially preterm infants. The objective of this study was to determine the incidence and the mortality of early onset (EOS) and late onset sepsis (LOS) with positive blood culture in newbom infants admitted at Neonatal Intensive Care Unit (NICU) during tive years, and to compare clinical and laboratory data in EOS vs LOS and according to etiological agents. A retrospective study was conducted of NICU newbom infants who had positive blood culture during 1999-2003. The newborn infants who had growth of more than one agent in the same blood culture or the growth of contaminant agents without clinical correlation were excluded. Comparison was performed in newborn with EOS vs LOS and according to etiological agents (Gram-positive vs Gram-negative vs Fungus}. Variables studied: incidence and mortality; c1inical data (birth weight, gestational, age, post-natal age, sex, risk factors for EOS and LOS); laboratorial data (blood count, C reactive protein, agents in blood culture). Statistical analyses: Student t test for parametric, Chi-square tesCfor non parametric variables, and ANOVA, with 5% of signiticance. The incidence of blood culture proven sepsis was 11% with 1,5% of EOS and 9,5% of LOS. The mortality rate was 29,5% and it was higher in EOS vs. LOS (34% vs 25%). Prernaturity and low birth weight were the main clinical characteristics in septic newborn. Gestational age and birth weight were lower in LOS. Leukocytes indices were significantly higher in EOS. The main risk factors were premature rupture of membranes and previous antibiotic use in EOS and LOS respectively. E coli and group B streptococci were the main agents for EOS and eoagulase negative staphyloeoeci... (Complete abstract, click electronic access below)
Sepsis is an important cause of neonatal morbidity and mortality , specially preterm infants. The objective of this study was to determine the incidence and the mortality of early onset (EOS) and late onset sepsis (LOS) with positive blood culture in newbom infants admitted at Neonatal Intensive Care Unit (NICU) during tive years, and to compare clinical and laboratory data in EOS vs LOS and according to etiological agents. A retrospective study was conducted of NICU newbom infants who had positive blood culture during 1999-2003. The newborn infants who had growth of more than one agent in the same blood culture or the growth of contaminant agents without clinical correlation were excluded. Comparison was performed in newborn with EOS vs LOS and according to etiological agents (Gram-positive vs Gram-negative vs Fungus}. Variables studied: incidence and mortality; c1inical data (birth weight, gestational, age, post-natal age, sex, risk factors for EOS and LOS); laboratorial data (blood count, C reactive protein, agents in blood culture). Statistical analyses: Student t test for parametric, Chi-square tesCfor non parametric variables, and ANOVA, with 5% of signiticance. The incidence of blood culture proven sepsis was 11% with 1,5% of EOS and 9,5% of LOS. The mortality rate was 29,5% and it was higher in EOS vs. LOS (34% vs 25%). Prernaturity and low birth weight were the main clinical characteristics in septic newborn. Gestational age and birth weight were lower in LOS. Leukocytes indices were significantly higher in EOS. The main risk factors were premature rupture of membranes and previous antibiotic use in EOS and LOS respectively. E coli and group B streptococci were the main agents for EOS and eoagulase negative staphyloeoeci... (Complete abstract, click electronic access below)
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Palavras-chave
Neonatologia, Medicina de emergencia, Unidade de tratamento intensivo, Infecções neonatias - Unidade de Tratamento Intensivo
Como citar
SILVA, Geraldo Henrique Soares da. Análise clínica e laboratorial da sepse com hemocultura positiva em recém-nascidos internados em Unidade de Terapia Intensiva Neonatal durante 5 anos. 2007. 124 f. +. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.