Invasive devices as risk factors for neonatal sepsis in neonatal intensive care units
DOI:
https://doi.org/10.33448/rsd-v9i12.11048Keywords:
Sepsis; Pregnancy Complications, Infectious; Child health services.Abstract
This study aimed to evaluate the impact of invasive devices as risk factors for the development of neonatal sepsis in Neonatal Intensive Care Units. Hospital-based retrospective cohort study performed in two Neonatal Intensive Care Units in Ponta Grossa, Paraná, Brazil. Documentary data were collected through consultation of electronic medical charts of all patients admitted to two hospitals and of the patients with diagnosis of sepsis in another hospital. Health conditions at admission and outcomes were evaluated. Frequencies of the reasons for admission and the outcomes were calculated. In the association analysis, exposure variables were calculated with odds ratio and confidence intervals (95%). The frequency of sepsis was 39%, and 45.7% of the cases were of early-onset sepsis and 54.3% of late-onset sepsis. The mortality rate associated with sepsis was 9.9%. The use of invasive devices was observed to increase by 6 times the risk of neonatal sepsis. Peripherally inserted central catheter and phlebotomy were the devices causing higher risk. The high incidence of late-onset sepsis, its association with the use of invasive devices and the higher mortality rate among newborns with sepsis suggest the presence of fragilities in neonatal care and the need to seek alternatives of neonatal approach to avoid new cases of neonatal sepsis and consequent death.
References
Alcock, G., Liley H. G., Cooke, L., Gray, P. H. (2017). Prevention of neonatal late-onset sepsis: a randomized controlled trial. BMC Pediatrics, 17(98), 1-7. https://doi.org/10.1186/s12887-017-0855-3
Black, R. E., Laxminarayan, R., Temmerman, M., & Walker, N. (Eds.). (2016). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). The International Bank for Reconstruction and Development / The World Bank.
Frank, B. R. B., Toso, B. R. G. O., Viera, C. S., Guimarães, A. T. B., Caldeira, S. (2016). Evaluation of the implementation of the Rede Mãe Paranaense in three Health Regions of Paraná. Saúde Debate, 40(109), 163-174. DOI: 10.1590/0103-1104201610913
Giannoni, E., Agyeman, P., Stocker, M., Posfay-Barbe, K. M., Heininger, U., Spycher, B. D., Bernhard-Stirnemann, S., Niederer-Loher, A., Kahlert, C. R., Donas, A., Leone, A., Hasters, P., Relly, C., Riedel, T., Kuehni, C., Aebi, C., Berger, C., Schlapbach, L. J., & Swiss Pediatric Sepsis Study (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.e4. https://doi.org/10.1016/j.jpeds.2018.05.048
Gokce, I. K., Kutman, H., Uras, N., Canpolat, F. E., Dursun, Y., & Oguz, S. S. (2018). Successful Implementation of a Bundle Strategy to Prevent Ventilator-Associated Pneumonia in a Neonatal Intensive Care Unit. Journal of tropical pediatrics, 64(3), 183–188. https://doi.org/10.1093/tropej/fmx044
Hornik, C. P., Fort, P., Clark, R. H., Watt, K., Benjamin, D. K., Jr, Smith, P. B., Manzoni, P., Jacqz-Aigrain, E., Kaguelidou, F., & Cohen-Wolkowiez, M. (2012). Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early human development, 88 Suppl 2(Suppl 2), S69–S74. https://doi.org/10.1016/S0378-3782(12)70019-1
Resende, D. S. & Do Ó, J. M. (2011). Reduction of catheter-associated bloodstream infecctions through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil. Revista da Sociedade Brasileira de Medicina Tropical, 44(6), 731-734. http://dx.doi.org/10.1590/S0037-86822011000600015
Rosa, N. P. da, Oliveira, D. C., Jantsch, L. B., & Neves, E. T. (2020). Agravos agudos de saúde de bebês prematuros moderados e tardios no período neonatal. Research, Society and Development, 9(7), e251974156. https://doi.org/10.33448/rsd-v9i7.4156
Shane, A. L., Sánchez, P. J., Stoll, B. J. (2017). Neonatal sepsis. The Lancet, 390(10104), 1770-1780. https://doi.org/10.1016/S0140-6736(17)31002-4
Shane, A. L., & Stoll, B. J. (2014). Neonatal sepsis: progress towards improved outcomes. The Journal of infection, 68 Suppl 1, S24–S32. https://doi.org/10.1016/j.jinf.2013.09.011
Schindler, T., Koller-Smith, L., Lui, K., Bajuk, B., Bolisetty, S., & New South Wales and Australian Capital Territory Neonatal Intensive Care Units’ Data Collection (2017). Causes of death in very preterm infants cared for in neonatal intensive care units: a population-based retrospective cohort study. BMC pediatrics, 17(1), 59. https://doi.org/10.1186/s12887-017-0810-3
Silveira, R.C. & Procianoy, R. S. (2012). A recent review on neonatal sepsis. Boletim Científico de Pediatria. 1(1), 29-35.
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 : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 15(6), 523–528. https://doi.org/10.1097/PCC.0000000000000157
Wynn J. L. (2016). Defining neonatal sepsis. Current opinion in pediatrics, 28(2), 135–140. https://doi.org/10.1097/MOP.0000000000000315
World Health Organization (2012). Born too soon: The Global Action Report on Preterm Birth. https://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf.
Global Maternal and Neonatal Sepsis Initiative Working Group. Electronic address: bonetm@who.int (2017). The Global Maternal and Neonatal Sepsis Initiative: a call for collaboration and action by 2030. The Lancet. Global health, 5(4), e390–e391. https://doi.org/10.1016/S2214-109X(17)30020-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Juliana Barbosa Schwab ; Erildo Vicente M¨¨¨¨¨¨uller ; Elisa Donalisio Teixeira Mendes; Pollyanna Kássia de Oliveira Borges ; Taís Ivastcheschen
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.