High Incidence Rates of Early-onset Bacterial Sepsis in Infants Born in Two Brazilian Maternities: A 15-Year Retrospective Analysis.
Pediatr Infect Dis J
; 43(3): 271-277, 2024 Mar 01.
Article
in En
| MEDLINE
| ID: mdl-38241655
ABSTRACT
BACKGROUND:
Data on the burden and etiology of neonatal early-onset bacterial sepsis (EOBS) in low-to-middle-income countries are scarce. Surveillance is critical for optimizing prevention and treatment strategies. We aimed to estimate the incidence of EOBS in 2 large Brazilian cohorts of neonates.METHODS:
Data were retrospectively obtained from 33,794 neonates born between 2009 and 2017 at low-risk (n = 17,981) and high-risk maternity centers (n = 15,813). Blood cultures were taken within 72 hours of life from neonates with perinatal risk factors for EOBS or suspected EOBS. A positive blood culture for a pathogenic microorganism and a compatible clinical evolution confirmed the diagnosis of EOBS.RESULTS:
One-third of the infants born from high-risk and 18.5% from low-risk maternities were investigated for EOBS. Overall, EOBS was more incident in neonates born in the high-risk facilities [66 cases or 4.2/1000 (95% CI 3.2-5.3)] than in the low-risk facilities [24 cases or 1.3/1000 (95% CI 0.9-2.0)]. The incidence rate of EOBS increased with decreasing gestational age (<32 weeks 20.5/1000; 32-36 weeks 5.6/1000; ≥37 weeks 1.5/1000). Group B Streptococcus (GBS) was the agent more frequently identified in high-risk and low-risk maternities 1.8/1000 (95% CI 1.1-2.4) and 0.4/1000 (95% CI 0.2-0.9), respectively. EOBS's overall case fatality rate was 17.8% for all the agents and 22% for GBS.CONCLUSIONS:
EOBS remains unacceptably high and is frequently fatal in preterm and term infants cared for in high- or low-risk maternities. Because GBS has emerged as the most frequent causative agent, preventive strategies are urgently needed.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Streptococcal Infections
/
Sepsis
Type of study:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Newborn
/
Pregnancy
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Pediatr Infect Dis J
/
Pediatr. infect. dis. j
/
Pediatric infectious disease journal
Journal subject:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Year:
2024
Document type:
Article
Country of publication: