Late-onset sepsis and mortality among neonates in a Brazilian Intensive Care Unit: a cohort study and survival analysis

Epidemiology and Infection - Tập 147 - 2019
Felipe Teixeira de Mello Freitas1,2, A. F. O. L. Araujo1, Maria Isa Souza Lacerda de Melo1, Gustavo Adolfo Sierra Romero2
1Hospital Materno Infantil de Brasília, Health Secretariat of Distrito Federal, Brasilia, Brazil and
2Nucleo de Medicina Tropical, University of Brasilia, Brasilia, Brazil

Tóm tắt

AbstractA cohort study was performed from January 2014 to December 2016 in a Brazilian neonatal intensive care unit, including neonates with high risk for infection and death. We estimated bloodstream infection (BSI) incidence and conducted a survival analysis, considering the time to death and to the first episode of BSI as outcomes, comparing very low birth weight (VLBW) neonates with the remaining neonates. An extended Cox model was performed and the hazard ratio (HR) was calculated for different time periods. The study had 1560 neonates included, the incidence and the incidence density of BSI was 22% and 18.6 per 1000 central venous catheter-days, respectively. Considering VLBW neonates as the reference group, the HR for time to death was 4.06 (95% CI 2.75–6.00,P< 0.01) from day 0 to 60 and for time to the first episode of BSI was 1.76 (95% CI 1.31–2.36,P< 0.01) from day 0 to 36. Having the heavier neonates group as reference, the HR for time to the first episode of BSI was 2.94 (95% CI 1.92–4.34,P< 0.01) from day 37 to 90. Late-onset neonatal sepsis prevention measures should consider the differences in risk during time, according to neonates' birth weight.

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Tài liệu tham khảo

10.1007/s12098-014-1406-7

Leistner, 2013, Nosocomial infections in very low birth weight infants in Germany: current data from the National Surveillance System NEO–KISS, Klinische Padiatrie, 225, 75, 10.1055/s-0033-1334886

10.1086/668425

10.1016/j.ajic.2016.08.007

10.1590/0037-8682-0101-2014

10.1016/j.ajic.2006.06.013

10.1016/S0022-3476(05)82056-6

10.1016/S0022-3476(78)80621-0

10.1016/S0022-3476(88)80699-1

Brazilian Institute of Geography and Statistics. Estimativas de população dos municípios brasileiros com data referencia em 1o de julho de 2014. Available at http://www.ibge.gov.br/home/presidência/noticias/pdf/analise_estimativas_2014.pdf (Accessed 21 January 2017).

10.1097/INF.0000000000000031

10.1016/S0378-3782(12)70019-1

Inter-Agency Health Information Network (RIPSA). Proporção de partos hospitalares. Available at http://tabnet.datasus.gov.br/cgi/tabcgi.exe?idb2012/f07.def (Accessed 31 March 2017).

Cox, 1972, Regression models and life tables (with discussion), Journal of the Royal Statistical Society, 34, 187, 10.1111/j.2517-6161.1972.tb00899.x

10.1093/biomet/67.1.145

10.1002/sim.4780030207

10.1016/j.jhin.2007.06.004

10.1590/S1415-790X2013000100008

Lutsar, 2014, Current management of late onset neonatal bacterial sepsis in five European countries, European Journal of Pediatrics, 173, 997

2013, Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement. CLSI Document M100–S23

10.1080/01621459.1958.10501452

10.1016/j.ajic.2006.01.002

10.1038/jp.2012.36

10.1590/S0034-89102008000500023

Adair, 2003, Risk factors for early-onset group B streptococcal disease in neonates: a population-based case-control study, Canadian Medical Association Journal, 169, 198

10.1016/S0146-0005(03)00046-6

10.1016/j.jhin.2007.08.019

Mantel, 1966, Evaluation of survival data and two new rank order statistics arising in its consideration, Cancer Chemotherapy Reports, 50, 163

2014, Every Newborn: an Action Plan to End Preventable Deaths

10.1086/502475

2013, Critérios Diagnósticos de Infecção Relacionada à Assistência à Saúde – Neonatologia

10.1136/archdischild-2017-313362

2015, Transforming Our World: The 2030 Agenda for Sustainable Development

10.1016/j.earlhumdev.2010.01.012

10.1371/journal.pone.0052342

2015, Saúde Brasil 2014: uma análise da situação de saúde e das causas externas

10.1093/tropej/fmu038

10.1371/journal.pone.0148343

10.1093/eurpub/ckx131

10.1016/B978-1-4160-6400-8.00002-X