Perfil epidemiológico de neonatos prematuros com infecção neonatal tardia: situação de uma UTIN brasileira

Abstract

Objectives: To describe the epidemiological profile of preterm infants admitted to a neonatal intensive care unit (NICU) in Brazil, analyze risk factors for late infection and describe isolated etiologic agents in microbiological cultures of patients. Methods: A cohort study of newborns with less than 37 weeks of gestational age admitted for at least five consecutive days in the NICU of Nossa Senhora de Lourdes Maternity, Aracaju, Northeast-Brazil, during the months of August 2014 and March 2015. Results: The studied sample consisted of 155 preterm infants, predominantly male (54.2%), born vaginally (55.5%), with mean gestational age (standard deviation) of 31.7 (± 2.8) weeks, the median (interquartile range) birth weight of 1468.5 (1115.8 to 1752.5) grams. Late infection rate was 31.6%, and the most frequent diagnosis was clinical sepsis (45%). Gram-negative bacteria were the most frequently isolated agents (50%) from the tests of microbiological cultures. Mechanical ventilation was a risk factor associated with late neonatal infection OR = 1.3 (95% CI: 1.14 to 1.42; p <0.001). Overall mortality was 16.1%, being higher in patients with late infection and premature infants. Conclusions: In this sample, late neonatal infection and prematurity were important causes of morbidity and mortality in neonates admitted to the NICU. Mechanical ventilation was a risk factor for late-onset neonatal infection. Gram-negative bacteria are the most common causative agents of proven infections.