Diagnosis of early neonatal sepsis in a neonatal referral unit: 10-year cohort

Roberta Maia de Castro Romanelli, Bárbara Silveira Faria, Samya Ladeira Vieira, Leni Márcia Anchieta, Janita Ferreira, Viviane Rosado, Fernanda Eugênia Lapa Marinho, Paulo Henrique Orlandi Mourão

Resumo


Background - The neonatal mortality corresponds to almost half of deaths in children under 5 years old, according to information from the World Health Organization, the neonatal sepsis is the cause of a significant portion of these deaths. The non-specific clinical findings and the low sensitivity of blood culture hinder the diagnosis of sepsis and contribute to the overuse of antibiotics. Objective - to describe the epidemiological profile and diagnosis of HAI and early neonatal sepsis in a referral neonatal unit. Methods – This is a cohort made in a neonatal unit of reference for high obstetric risk and neonatal care. Results - It was observed that most cases of sepsis and health-related infections (HAIs) were used as clinical sepsis without a specific location, with a higher incidence in neonates of lower weight, that is the main isolated Gram-positive microorganism. The Empirical antibiotic therapy was introduced in these cases and propaedeutics performed contributed to the definitive diagnosis or suspension of antimicrobials, when the suspicion of infection was ruled out. Conclusion - A low percentage of microorganism isolation was observed in cases of early neonatal sepsis with a large number of clinical neonatal sepsis cases treated with antimicrobials. The need for a more accurate diagnosis to reduce empirical impacts is emphasized, and the use of tools that use clinical symptoms and maternal risk factors to reduce their use is recommended.

Key words:  Neonatal sepsis; Streptococcus agalactiae; newborn, infant; Diseases; Antimicrobial         agents.


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