CLINICAL AND MICROBIOLOGICAL FEATURES OF EARLY-ONSET NEONATAL SEPSIS IN PRETERM INFANTS
Аннотация
Early-onset neonatal sepsis (EONS) remains the leading cause of morbidity and mortality, especially among premature infants. Conducting high-quality epidemiological monitoring is an important condition for effective tactics treatment neonatal infections and improving the quality of medical care for this category of newborn.
The aim. Determination of the value of microbiological triggers in the blood in various clinical options for EONS in preterm infants.
Materials and methods. Clinical and microbiological data on 50 prematurely born newborns with EONS were selected. The analysis of the frequency of detected bacteremia, the distribution of pathogenic microorganisms and the clinical characteristics of neonatal sepsis.
Results. In the study, sources of infection were detected in 94 % of cases. Positive blood cultures were obtained in 17 (34 %) newborns with EONS. 61.5 % of all cases of bacteremia were caused by coagulase-negative staphylococcus (CoNS). Gram-negative pathogens were detected in 23.5 % of positive blood cultures, representatives of this group were Escherichia coli and Klebsiella pneumonia. The overall mortality rate from EONS was 30 %.
Conclusions. The incidence of sepsis confirmed by a positive blood culture was 34 %. The most common cause of EONS is CoNS, low incidence of group B Streptococcus sepsis has been established. The most frequent septicopymic sources of infection were the lungs, which is expressed in the high incidence (94 %) of X-ray pneumonia in the structure of the EONS.
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Литература
Sharma, D., Farahbakhsh, N., Shastri, S., Sharma, P. (2017). Biomarkers for diagnosis of neonatal sepsis: a literature review. The Journal of Maternal-Fetal & Neonatal Medicine, 31 (12), 1646–1659. doi: http://doi.org/10.1080/14767058.2017.1322060
Puopolo, K. M., Benitz, W. E., Zaoutis, T. E. (2018). Management of Neonates Born at ≤34 6/7 Weeks’ Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics, 142 (6), e20182896. doi: http://doi.org/10.1542/peds.2018-2896
Belachew, A., Tewabe, T. (2020). Neonatal sepsis and its association with birth weight and gestational age among admitted neonates in Ethiopia: systematic review and meta-analysis. BMC Pediatrics, 20 (1), 55. doi: http://doi.org/10.1186/s12887-020-1949-x
Cai, S., Thompson, D. K., Anderson, P. J., Yang, J. Y.-M. (2019). Short- and Long-Term Neurodevelopmental Outcomes of Very Preterm Infants with Neonatal Sepsis: A Systematic Review and Meta-Analysis. Children, 6 (12), 131. doi: http://doi.org/10.3390/children6120131
Zea-Vera, A., Ochoa, T. J. (2015). Challenges in the diagnosis and management of neonatal sepsis. Journal of Tropical Pediatrics, 61 (1), 1–13. doi: http://doi.org/10.1093/tropej/fmu079
Schrag, S. J., Farley, M. M., Petit, S., Reingold, A., Weston, E. J., Pondo, T. et. al. (2016). Epidemiology of Invasive Early-Onset Neonatal Sepsis, 2005 to 2014. PEDIATRICS, 138 (6). doi: http://doi.org/10.1542/peds.2016-2013
Fjalstad, J. W., Stensvold, H. J., Bergseng, H., Simonsen, G. S., Salvesen, B., Ronnestad, A. E., Klingenberg, C. (2016). Early-onset Sepsis and Antibiotic Exposure in Term Infants: A Nationwide Population-based Study in Norway. The Pediatric Infectious Disease Journal, 35 (1), 1–6. doi: http://doi.org/10.1097/inf.0000000000000906
Braye, K., Foureur, M., de Waal, K., Jones, M., Putt, E., Ferguson, J. (2019). Epidemiology of neonatal early-onset sepsis in a geographically diverse Australian health district 2006-2016. PLOS ONE, 14 (4), e0214298. doi: http://doi.org/10.1371/journal.pone.0214298
Giannoni, E., Agyeman, P. K. A., Stocker, M., Posfay-Barbe, K. M., Heininger, U., Spycher, B. D. et. al. (2018). Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study. The Journal of Pediatrics, 201, 106–114. doi: http://doi.org/10.1016/j.jpeds.2018.05.048
Anderson-Berry, A., Bellig, L., Ohning, B. (2015). Neonatal sepsis: MedlinePlus Medical Encyclopedia. Available at: https://medlineplus.gov/ency/article/007303.htm
Wynn, J. L. (2016). Defining neonatal sepsis. Current Opinion in Pediatrics, 28 (2), 135–140. doi: http://doi.org/10.1097/mop.0000000000000315
Wynn, J. L., Polin, R. A. (2017). Progress in the management of neonatal sepsis: the importance of a consensus definition. Pediatric Research, 83 (1), 13–15. doi: http://doi.org/10.1038/pr.2017.224
Wojkowska-Mach, J., Chmielarczyk, A., Strus, M., Lauterbach, R., Heczko, P. (2019). Neonate Bloodstream Infections in Organization for Economic Cooperation and Development Countries: An Update on Epidemiology and Prevention. Journal of Clinical Medicine, 8 (10). doi: http://doi.org/10.3390/jcm8101750
Huggard, D., Powell, J., Kirkham, C., Power, L., O’Connell, N. H., Philip, R. K. (2019). Time to positivity (TTP) of neonatal blood cultures: a trend analysis over a decade from Ireland. The Journal of Maternal-Fetal & Neonatal Medicine, 1–7. doi: http://doi.org/10.1080/14767058.2019.1617687
Dillenseger, L., Langlet, C., Iacobelli, S., Lavaux, T., Ratomponirina, C., Labenne, M., Kuhn, P. (2018). Early Inflammatory Markers for the Diagnosis of Late-Onset Sepsis in Neonates: The Nosodiag Study. Front Pediatr, 6, 346. doi: http://doi.org/10.3389/fped.2018.00346
Wynn, J. L., Wong, H. R., Shanley, T. P., Bizzarro, M. J., Saiman, L., Polin, R. A. (2014). Time for a Neonatal-Specific Consensus Definition for Sepsis. Pediatric Critical Care Medicine, 15 (6), 523–528. doi: http://doi.org/10.1097/pcc.0000000000000157
Klingenberg, C., Kornelisse, R. F., Buonocore, G., Maier, R. F., Stocker, M. (2018). Culture-Negative Early-Onset Neonatal Sepsis – At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship. Front Pediatr, 6, 285. doi: http://doi.org/10.3389/fped.2018.00285
Lacaze-Masmonteil, T., Rosychuk, R. J., Robinson, J. L. (2013). Value of a single C-reactive protein measurement at 18 h of age. Archives of Disease in Childhood – Fetal and Neonatal Edition, 99 (1), F76–F79. doi: http://doi.org/10.1136/archdischild-2013-303984
Fjalstad, J. W., Stensvold, H. J., Bergseng, H., Simonsen, G. S., Salvesen, B., Ronnestad, A. E., Klingenberg, C. (2016). Early-onset Sepsis and Antibiotic Exposure in Term Infants: A Nationwide Population-based Study in Norway. The Pediatric Infectious Disease Journal, 35 (1), 1–6. doi: http://doi.org/10.1097/inf.0000000000000906
Cantey, J. B., Wozniak, P. S., Pruszynski, J. E., Sánchez, P. J. (2016). Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study. The Lancet Infectious Diseases, 16 (10), 1178–1184. doi: http://doi.org/10.1016/s1473-3099(16)30205-5
Ting, J. Y., Synnes, A., Roberts, A., Deshpandey, A., Dow, K., Yoon, E. W. (2016). Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis. JAMA Pediatr, 170 (12), 1181–1187. doi: http://doi.org/10.1001/jamapediatrics.2016.2132
Mohsen, L., Ramy, N., Saied, D., Akmal, D., Salama, N., Abdel Haleim, M. M., Aly, H. (2017). Emerging antimicrobial resistance in early and late-onset neonatal sepsis. Antimicrobial Resistance & Infection Control, 6 (1). doi: http://doi.org/10.1186/s13756-017-0225-9
Cotten, C. M. (2016). Adverse consequences of neonatal antibiotic exposure. Current Opinion in Pediatrics, 28 (2), 141–149. doi: http://doi.org/10.1097/mop.0000000000000338
Cailes, B., Kortsalioudaki, C., Buttery, J., Pattnayak, S., Greenough, A., Matthes, J. et. al. (2017). Epidemiology of UK neonatal infections: the neonIN infection surveillance network. Archives of Disease in Childhood – Fetal and Neonatal Edition, 103 (6), F547–F553. doi: http://doi.org/10.1136/archdischild-2017-313203
Kuhn, P., Dheu, C., Bolender, C., Chognot, D., Keller, L., Demil, H., Astruc, D. (2010). Incidence and distribution of pathogens in early-onset neonatal sepsis in the era of antenatal antibiotics. Paediatr Perinat Epidemiol, 24 (5), 479-487. doi: http://doi.org/10.1111/j.1365-3016.2010.01132.x
Ohlin, A., Björkman, L., Serenius, F., Schollin, J., Källén, K. (2015). Sepsis as a risk factor for neonatal morbidity in extremely preterm infants. Acta Paediatrica, 104 (11), 1070–1076. doi: http://doi.org/10.1111/apa.13104
Shin, Y.-J., Ki, M., Foxman, B. (2009). Epidemiology of neonatal sepsis in South Korea. Pediatrics International, 51 (2), 225–232. doi: http://doi.org/10.1111/j.1442-200x.2008.02685.x
Drageset, M., Fjalstad, J. W., Mortensen, S., Klingenberg, C. (2017). Management of early-onset neonatal sepsis differs in the north and south of Scandinavia. Acta Paediatrica, 106 (3), 375–381. doi: http://doi.org/10.1111/apa.13698
Leal, Y. A., Álvarez-Nemegyei, J., Velázquez, J. R., Rosado-Quiab, U., Diego-Rodríguez, N., Paz-Baeza, E., Dávila-Velázquez, J. (2012). Risk factors and prognosis for neonatal sepsis in southeastern Mexico: analysis of a four-year historic cohort follow-up. BMC Pregnancy and Childbirth, 12 (1). doi: http://doi.org/10.1186/1471-2393-12-48
Ozkan, H., Cetinkaya, M., Koksal, N., Celebi, S., Hacımustafaoglu, M. (2014). Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period: Coagulase-negativeStaphylococcusas the predominant pathogen. Pediatrics International, 56 (1), 60–66. doi: http://doi.org/10.1111/ped.12218
Klinger, G., Levy, I., Sirota, L., Boyko, V., Lerner-Geva, L., Reichman, B. (2010). Outcome of Early-Onset Sepsis in a National Cohort of Very Low Birth Weight Infants. PEDIATRICS, 125 (4), e736–e740. doi: http://doi.org/10.1542/peds.2009-2017
Wójkowska-Mach, J., Borszewska-Kornacka, M., Domańska, J., Gadzinowski, J., Gulczyńska, E., Helwich, E. et. al. (2012). Early-onset Infections of Very-low-birth-weight Infants in Polish Neonatal Intensive Care Units. The Pediatric Infectious Disease Journal, 31 (7), 691–695. doi: http://doi.org/10.1097/inf.0b013e3182567b74
Liang, L., Kotadia, N., English, L., Kissoon, N., Ansermino, J. M., Kabakyenga, J. et. al. (2018). Predictors of Mortality in Neonates and Infants Hospitalized With Sepsis or Serious Infections in Developing Countries: A Systematic Review. Frontiers in Pediatrics, 6. doi: http://doi.org/10.3389/fped.2018.00277
Wen, L., Xu, L. (2020). The efficacy of dopamine versus epinephrine for pediatric or neonatal septic shock: a meta-analysis of randomized controlled studies. Italian Journal of Pediatrics, 46 (1). doi: http://doi.org/10.1186/s13052-019-0768-x
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