Factores de riesgo asociados a Sepsis Bacteriana en recién nacidos prematuros de la Unidad de Cuidados Intensivos Neonatales del Hospital de Especialidades Teodoro Maldonado Carbo desde enero 2021 a diciembre 2022.

Abstract

Introduction: In Ecuador, according to INEC 2019, neonatal bacterial sepsis was the third cause of infant morbidity, with a number of 7,164 reports, that is, 7 neonates presented sepsis per 1,000 live births. Furthermore, it was the second cause of infant mortality in the country, with a percentage of 10% corresponding to 200 deaths, that is, 0.2 newborns per 1,000. Objectives: To relate the risk factors associated with bacterial sepsis in premature newborns in the Neonatal Intensive Care Unit of the Teodoro Maldonado Carbo Specialty Hospital from January 2021 to December 2022. Methodology: It is an observational, retrospective, cross-sectional and relational study where the patient population was 1112 premature patients and 612 neonates with a diagnosis of neonatal sepsis. The sample was 163 neonates. Results: When performing a culture, no causative pathogen was found in 128 of the cases (78.53%), while, of the cases with a confirmed diagnosis of sepsis, it was discovered that the most frequently found bacteria was Klebsiella pneumoniae in 14 of the cases. The results when associating early neonatal risk factors with the type of sex were sex p=0.656, weight p>0.148, fetal distress p=0.193, the presence of non-meconium p=0.193, Apgar stratification p=0.035 , when staging the Ballard p=0.016. Regarding maternal risk factors, preeclampsia with p=0.55, eclampsia p=0.022, p=0.242, chorioamnionitis p=0.466 and IVU with p= 0.84. At discharge, 149 neonates survived, of which 67 were female and 82 were male. Where the calculated mortality rate was 8.59% vs the survival rate 91.41% Conclusions: In this study, the weight of premature newborns with sepsis is not related to the type of sepsis (p=0.148). However, it was found that early sepsis is related to gestational age between 21 to 36 weeks (p=0.016), Apgar at minute 5 from 7 to 10 (p=0.035). Regarding maternal risk factors, eclampsia (p=0.022). Furthermore, when determining the most predominant pathogen, it was Klebsiella pneumoniae (68.97%). Finally, the mortality rate due to sepsis was 8.59%. Where the mortality rate found was 8.59%.