Lethality by neonatal sepsis, risk factors and microbiological characteristics

Abstract

Neonatal sepsis is one of the leading causes of death in this population and is related to gestational and perinatal factors as well as factors inherent in the newborn. Objective: To associate perinatal, neonatal, and microbiological factors to sepsis mortality. Patients and Method: Retrospective ca-se-control study of hospitalized newborns with confirmed neonatal sepsis through blood cultures, from 2013 to 2019. Cases were defined as those patients with confirmed sepsis that presented a fatal outcome and controls as those newborns with confirmed sepsis without a fatal outcome. Cases and controls were compared regarding maternal, perinatal, neonatal, and microbiological factors for quantitative variables in order to identify the trend and concentration of the variables studied. Results: Eleven cases were identified and three controls were randomly assigned to each case, stra-tified by gestational age groups. The median birth weight and gestational age were 1,004 grams and 28 weeks, respectively. Escherichia coli was identified in 21% of the patients, Candida parapsilosis in 16%, and Staphylococcus aureus in 14%. There was a statistically significant association between sepsis lethality and vaginal delivery (P = 0.023), infection before 7 days of life (P = 0.025), and Candida parapsilosis infection (P = 0.049). The multivariate analysis determined a statistically significant association between neonatal sepsis lethality and vaginal delivery and microbiological identification of Candida parapsilosis. Conclusion: Neonatal sepsis lethality was more frequent in the group of extremely preterm infants, newborns with history of vaginal delivery, early microbiological isolation, and t infection with Candida parapsilosis.