MICROBIAL LANDSCAPE OF THE NEONATAL INTENSIVE CARE UNIT: A RETROSPECTIVE ANALYSIS

Abstract

Objective. To investigate the structure, antenatal and intranatal risk factors and results of treatment of neonatal sepsis.Materials and methods. This study used analysis of 137 case histories of newborns from 2015 to 2019. We evaluated maternal risk factors, intrapartum asphyxia, duration of treatment, number of days on mechanical ventilation, the presence of sepsis, necrotic enterocolitis, mortality.Results and discussion. Most children were over 2500 g (69.3%). In infants with a birth weight lower than 1500 g were 10.9%. 70.8% of newborns received in the first 24 hours after birth. From the moment of admission to the department, among all infected children was 71%, mortality was 14%. In children under 29 weeks of gestation, the risk of developing sepsis is 17.2 times higher. (р˂0.001) In children under 1 kg of weight, the risk of manifestation of sepsis is 42.2 times higher. (р˂0.001)The maternal colonization have the risk of developing a child’s infection is 4.36 times higher. (р˂0.001)With a diagnosis of sepsis most infants were more than 2.5 kg and mortality remained significantly high 31.6-36.8% in all weight groups (0.00001), depending on birth weight.The majority of the applicants were children over 37 weeks, but mortality was significantly higher in the group from 29-37 weeks (0.00001), depending on the term of gestation.Among the studied mothers, up to 53% were maternal colonization and in this group the mortality of children was significantly higher than 23% (p=0.020).However, in the group of children where there were signs of ascending infection of the placenta (there were 25%) mortality was still significantly higher by 1.4 times, 32% (p=0,008).Conclusions. The risk of developing neonatal sepsis was increased in ascending infection (clinical chorioamnionitis) in 6.65 times, (р˂0.001), the presence of a coagulase-negative culture by 5.83 (р˂0.011) and invasive respiratory therapy by 18.52 times. (р˂0.002) Mortality rates are affected by gestational age OR=13.81 (р˂0.001), birth weight 1-1.5 kg OR=13.15 (р˂0.001), 1.5-2.5 kg OR=2.86 (р=0.043), maternal factors (vaginal colonization, ascending infection) OR=3,22 (р˂0.023), infection of placental membranes OR=4,32 (р˂0.008), the presence of sepsis OR=15,56 (р˂0.001), necrotic enterocolitis OR=8,06 (р˂0.001) and CoNS OR=4,98 (р˂0.033).