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2012, Number 1

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Rev Mex Pediatr 2012; 79 (1)

Early neonatal sepsis. When to initiate antibiotic?

Islas DLP, Cardiel ML, Sánchez MÓ

Language: Spanish
References: 35
Page: 12-17
PDF size: 47.23 Kb.


ABSTRACT

Sepsis is a syndrome. The diagnosis is based on the clinical, perinatal history and serological tests. There is a dilemma in whom antibiotic should start and when to suspend it.
Material and methods. A prospective cohort transversal study was conducted. Included a total of 66 newborn (NB) of term. Studies were biometrics hematic (BH), C-reactive protein (CRP) peripheral blood culture. All the patients included in the study home antibiotic schema with ampicillin and amikacin. The presence of septicemia were in patients that requiring more than 72 hours of treatment with antibiotics.
Results. Developed sepsis the 27.2% (n = 18) and with germ at 6% (n = 4). In the 72.7% (n = 48) reject sepsis. Maternal chorioamnionitis and abdominal distention in the newly born were presented at 55% and 33.3 per cent, respectively, teaming up with sepsis.
Conclusions. The incidence of sepsis in this series is greater than the reported being the chorioamnionitis the main risk factor for developing sepsis. In most of the newborn with sepsis suspected did not require more than 72 hours use of antibiotic.


REFERENCES

  1. Klinger G, Levy I, Sirota L, Boyko V, Reichman B. Epidemiology and risk factors for early onset sepsis among very-low-birthweight infants. Am J Obstet Gynecol 2009; 201(1): 38.e1-6

  2. Kermorvant-Duchemin E, Laborie S, Rabilloud M, Laphillonne A, Claris O. Outcome and diagnostic factors in neonates with septic shock. Pediatr Crit Care Med 2008; 9(2): 186-91.

  3. Van den Hoogen A, Gerards LJ, Verboon-Macrolek MA, Fleer A, Krediet TG. Long-term trends in the epidemiology of neonatal sepsis and antibiotic susceptibility of causative agents. Neonatology 2009; 97(1): 22-8.

  4. Flores HH, Maida CR, Solís HH, Illescas ME. Identificación molecular de bacterias causales de sepsis neonatal mediante la reacción en cadena de la polimerasa. Acta Pediat Mex 2009; 30(3): 148-55.

  5. Tapia I, Reichhard T, Saldias R. Sepsis neonatal en la era de profilaxis antimicrobiana prenatal. Rev Chil Infect 2007; 24(2): 111-6.

  6. Sarkar S, Bhagat L, Decristofaro JD, Wiswell TE, Spitzer AR. A study of the role of multiple site blood cultures in the evaluation of neonatal sepsis. J Perinatol 2006; 26: 18-22.

  7. Rodríguez H. Sepsis neonatal por S. pyogenes. Acta Med Costarric 2009; 51(3): 175-8.

  8. Díaz M. Síndrome de shock tóxico neonatal por Streptococcus pyogenes. Rev Chil Infectol 2007; 24(5): 493-6.

  9. Ramírez S. Etiología de la sepsis neonatal en una unidad hospitalaria de segundo nivel. Salud Pública Mex 2007; 49(6): 391-3

  10. Trotman H, Bell Y. Neonatal sepsis in very low birth weight infants at the university hospital of the West Indies. West Indian Med Journal 2006; 55(3): 165-9.

  11. Schray S. Prevention of neonatal sepsis. Clin Perinatol 2005; 32(3): 601-15.

  12. Álvarez T, Montero R. Sepsis neonatal 1986-1996. Rev Esp Ped 1997: 419-24.

  13. Arredondo JL, Ortiz FJ. Etiología de la septicemia en una Unidad de Perinatología. Bol Hosp Infant Mex 1994: 317-23.

  14. López SJB, Coto GD. Neonatal sepsis of vertical transmission. An epidemiological study from the Grupo de Hospitales Castrillo. J Perinat Med 2000; 28(2): 309-15.

  15. Hodgman J. Sepsis in the neonate. Perinatol Neonatol 1981; 5(2): 45.

  16. Klein JO, Marcy SM. Bacterial sepsis and meningitis. In: Remington, Klein editors. Infectious diseases of the fetus and the newborn infant. 4th ed. Philadelphia: WB Saunders Co; 1995: 835-90.

  17. Voora S, Srinvasasn G, Lilien LD, Yeh TF, Pildes RS. Fever in full-term newborns in the first days of life. Pediatrics 1982; 69(1): 40-4.

  18. López R, Hernández MJ. Bacteremias verticales: ¿Tratar o no tratar? Anales Españoles de Pediatría 2001; 54(3): 160-4.

  19. Escobar G, De Kun L, Armstrong MA, Gardner M, Foler B, Verdi J et al. Neonatal sepsis workups in infants ‹ 2,000 grams at birth: A population-based study. Pediatrics 2000; 106: 256-61.

  20. Harris MC, Polin RA. Diagnosis of neonatal sepsis. In: Spitzer AR editors. Intensive care of the fetus and neonate. 2nd ed. Philadelphia: Elsevier Mosby; 2005: 1115-23.

  21. Suhouten-van Neeteren NY, Rietveld A, Moolenaar AJ, Van Bel F. Influence of perinatal conditions on C-reactive protein production. J Pediatr 2001; 120 (Pt 4): 621-4.

  22. Gibbs RS, Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol 1991; 164 (Pt 1): 1317-26.

  23. Hillier SL, Krohn MA, Kiviat NB, Watts DH, Eschenbach DA. Microbiologic causes and neonatal outcomes associated with chorioamnion infection. Am J Obstet Gynecol 1991; 165(Pt 1): 955-61.

  24. Harris MC, Casey J. Prevention and treatment of neonatal sepsis. In: Spitzer AR editors. Intensive care of the fetus and neonate. 2nd ed. Philadelphia: Elsevier Mosby; 2006: 1125-36.

  25. Saltigeral SP, Fernández DE, Macías PM, Rodríguez WMA, González SN. Sepsis neonatal: correlación entre antecedentes perinatales y agentes causales. Rev Enf Infec Pediatr 1993; 6(23): 51-4.

  26. López-Sastre JB, Pérez-Solís D. Definiciones de sepsis neonatal: un largo camino por recorrer. An Pediatr (Barc) 2006; 65: 525-8.

  27. Fischer JE, Harbarth S, Agthe AG, Benn A, Ringer SA, Goldmann DA et al. Quantifying uncertainly: physicians estimates of infection in critically ill neonates and children. Clin Infect Dis 2004; 38: 1383-90.

  28. Fischer JE. Physicians ability to diagnose sepsis in newborns and critically ill children. Pediatr Crit Care Med 2005; 6: 5120-55.

  29. Kilbride D, Powers RJ, Sheehan M. Implementation of evidence-based potentially better practices to decrease nosocomial infections. Pediatrics 2003; 111: 519-33.

  30. World Health Organization. Perinatal mortality: alisting of available information. Geneva WHO 1996. (Unpublished document WHO/FRH/MSM/96.7)

  31. López SJB, Coto CD. Neonatal sepsis of nosocomial origin: An epidemiological study from the Grupo de Hospitales Castrillo. J Perinat Med 2002; 30: 149-57.

  32. Siegel JD, McCraken GH Jr. Sepsis neonatorum. N Engl J Med 1981; 304(11): 642-7.

  33. Ungerer RLS, Lincetto O, Mcguire W, Saloojee H, Gulmezoglu AM. Antibióticos profilácticos versus selectivos para el tratamiento de recién nacidos a término de madres con factores de riesgo de infección neonatal. Revisión Cochrane traducida. Disponible en: http://www.update-software.com/pdf/CD003957.pdf

  34. Chiesa C, Pellegrini G, Panero A, Osborn JF, Signore F, Assumna M. C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: Influence of illness severity, antenatal and perinatal complications and infection. Clin Chem 2003; 49: 60-8.

  35. Chiesa C, Signiore F, Assumna M, Buffone E, Tramontozzi P, Osborn JF. Serial measurement of C-reactive protein and interleukin-6 in the immediate postnatal period: referent intervals and analysis of maternal and prenatal confounders. Clin Chem 2001; 47: 1016-22.




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