Fatores de risco para o desenvolvimento de sepse neonatal em unidades de terapia intensiva neonatais de hospitais dos Campos Gerais/

Abstract

INTRODUCTION: Neonatal sepsis is a condition with elevated incidence and implicates in high morbidity and mortality. OBJECTIVES: Evaluation of risk factors for neonatal sepsis in two Campos Gerais Tertiary Hospital Neonatal Intensive Care Units. METHODS: Epidemiologic, descriptive and analytic study, hospital based retrospective cohort, performed on two Neonatal ICUS at Campos Gerais. Data collect was documentary by checking electronic chart of all patients admitted at Hospital 1 from 01/01/2015 to 31/12/2017 and of the patients with sepsis diagnose from 01/01/2013 a 31/12/2017 at Hospital 2. Health conditions on admission at the ICU and outcomes (sepsis, healing, death) were evaluated. The frequency of the admission reasons were calculated as well as the frequency of the outcomes (specially neonatal sepsis). Historical trend of admission was evaluated with linear regression equation and seasonal month-to-month index. In association analysis, exposition variables for sepsis were calculated with OR and confidence intervals (95%). RESULTS: Prematurity was the main cause of admission. Sepsis frequency was 39%, 45,7% early onset sepsis and 54,3% late onset sepsis. Risk factors statistically significant for the development of sepsis were, vaginal delivery and use of invasive devices. Surfactant administration had a protective factor for infection. Death risk of the babies with sepsis was 2,8 times higher. Gentamicin was the only antibiotic related with decrease of death rates. CONCLUSION: The elevated incidence of late onset sepsis, its association with the use of invasive devices as well as higher mortality rate on babies with sepsis, suggests a neonatal care fragility. and the search for alternatives at neonatal approach are necessary to avoid new cases of neonatal sepsis and consequent death.