Infecção neonatal por Streptococcus agalactiae do grupo B e Escherichia coli

• Ano de defesa: 2020
• Autor(a) principal: Longo, Maria Cristina Barbosa [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Neonatal Sepsis; Infection Control; Streptococcus Agalactiae; Risk Factors; Escherichia Coli; Sepse Neonatal; Controle de infecções; Fatores de risco
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=9882685; https://hdl.handle.net/11600/64416

Neonatal sepsis is a major public health issue worldwide and is among the leading causes of morbidity and mortality in neonates, particularly in developing countries. It is an important component in increasing neonatal mortality rates and can lead to serious complications such as morbidity, with long-term impacts for those who survive despite relatively low numbers of cases in this population. Objectives: to verify mortality for early neonatal sepsis and what are the risk factors for neonatal sepsis caused by Streptococcus agalactiae of group B and Escherichia coli and the mortality and prevalence of microorganisms in an intensive care unit in a school hospital. Method: Observational study conducted between 2007 and 2017 with neonates with the diagnosis of clinical and/or laboratory sepsis admitted to the Neonatal Intensive Care Unit of Hospital São Paulo and search for evidence on the main risk factors for infection and neonatal sepsis with a Systematic Review and Meta-analysis, according to the recommendations of Cochrane Collaboration. Results: The results of this work will be presented in the form of two articles. In Article 1 16 were selected to compose the present study. The main risk factors for neonatal infection with GBS and E.Coli are low birth weight and prematurity. In the meta-analysis chart we identified the higher mortality for E.coli and/or GBS sepsis cases, with Odds ratio 3.54 (P < 0.00001). In article 2 181 neonates were included, 36 were excluded from the study because they did not have the complete data in the electronic records. The blood culture positivity rate was 15(10.3%) and there was no positive sample. The mortality rate was 22%. The most prevalent microorganisms were the coagulase-negative Staphylococcus (CONs) with 6(50%), Streptococcus agalactiae with 2(16.6%). Conclusion: In article 1, sepsis by E. Coli presented higher mortality. It was evident that premature and low birth weight newborns have more susceptibility to acquire infection and later sepsis caused by E. Coli and GBS. In article 2, the most prevalent microorganisms found in the study were CONs and GBS among the gram positive and gram negative E.coli bacteria, requiring in addition to specific measures for the prevention of GBS, prevention strategies for the other types of microorganisms that cause infection. In both studies it became evident that more nationwide studies are needed to investigate the etiologies of neonatal sepsis, to map and monitor its local epidemiology in order to carry out public policies with specific measures aimed at this public.