RESUMO
The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima. A LP was performed in 45/214 (21.0%) of sepsis evaluations and in 13/48 (27.1%) of culture-proven sepsis. Meningitis was diagnosed in 8/214 (3.7%) of the episodes and 8/45 (17.5%) of the evaluations that included an LP. The duration of treatment of the sepsis episodes without a LP and the episodes with a negative LP was similar, and shorter than the episodes with a positive LP. The use of LP in the evaluation of late-onset sepsis is low and can result in undiagnosed and undertreated meningitis. The use of LP in the evaluation of neonatal sepsis must be encouraged in the neonatal units.
Assuntos
Recém-Nascido de Baixo Peso , Sepse/diagnóstico , Punção Espinal , Estudos de Coortes , Humanos , Recém-NascidoRESUMO
RESUMEN El objetivo del estudio fue analizar el uso de la punción lumbar (PL) en las sospechas de sepsis neonatal tardía. Se utilizó una cohorte de 414 neonatos con peso al nacer <2000 g en tres hospitales de Lima. Se realizó la PL en 45/214 (21,0%) sospechas de sepsis y en 13/48 (27,1%) sepsis confirmadas por hemocultivo. Se diagnosticó meningitis en 8/214 (3,7%) sospechas y en 8/45 (17,5%) episodios en los que se realizó la PL. El tiempo de tratamiento de los episodios sin PL fue similar a los episodios de sepsis con meningitis descartada y menor a los episodios de meningitis. El uso de la PL es bajo, lo que puede resultar en meningitis no diagnosticadas y tratadas inadecuadamente. Es necesario reforzar la importancia de la PL en la evaluación de sepsis neonatal.
ABSTRACT The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima. A LP was performed in 45/214 (21.0%) of sepsis evaluations and in 13/48 (27.1%) of culture-proven sepsis. Meningitis was diagnosed in 8/214 (3.7%) of the episodes and 8/45 (17.5%) of the evaluations that included an LP. The duration of treatment of the sepsis episodes without a LP and the episodes with a negative LP was similar, and shorter than the episodes with a positive LP. The use of LP in the evaluation of late-onset sepsis is low and can result in undiagnosed and undertreated meningitis. The use of LP in the evaluation of neonatal sepsis must be encouraged in the neonatal units.
