Invasive devices as risk factors for neonatal sepsis in neonatal intensive care units

Authors

DOI:

https://doi.org/10.33448/rsd-v9i12.11048

Keywords:

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.

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Published

24/12/2020

How to Cite

SCHWAB , J. B.; M¨¨¨¨¨¨ULLER , E. V.; MENDES, E. D. T. .; BORGES , P. K. de O.; IVASTCHESCHEN, T. Invasive devices as risk factors for neonatal sepsis in neonatal intensive care units. Research, Society and Development, [S. l.], v. 9, n. 12, p. e27891211048, 2020. DOI: 10.33448/rsd-v9i12.11048. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/11048. Acesso em: 26 dec. 2024.

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Section

Health Sciences