Microbiological and therapeutic characteristics of confirmed neonatal sepsis at a hospital in Lima, Peru

Abstract

Objectives. To describe the microbiological and therapeutic characteristics of confirmed neonatal sepsis, and determine its incidence and mortality in the National Hospital Arzobispo Loayza (HNAL) from 2011 to 2012, Lima, Peru. Materials and Methods. Retrospective longitudinal study. Monitoring newborn with probable sepsis was performed, evaluating occurrence of positive blood culture. The characteristics of the newborn were obtained from medical records. The cumulative incidence of confirmed sepsis, mortality and fatality rate was determined. For quantitative variables was used the mean with standard deviation or median with ranges intercuatílicos. For qualitative variables was used relative frequencies and percentages. Results. The incidence of confirmed sepsis was 4.1 per 1 000 live births (95% CI 2.7 to 5.5). The mortality rate was 0.97 per 1 000 live births (95% CI 0.29 to 1.63) and the fatality rate was 23.5% (95% CI 9-37). The most frequent isolates were coagulase-negative Staphylococcus, followed by Staphylococcus aureus, both with high rates of resistance to oxacillin (90% and 66.6%, respectively). A 67% started with amipicilina / amikacin or ampicillin / cefotaxime. It was rotated antibiotics to 58% of newborn by poor clinical / laboratory evolution or blood culture result, initiating vancomycin to most (42.8%). Conclusions. There is a high incidence of confirmed sepsis and a high fatality rate. The treatment was not administered according to the microbiological profile.