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Sepsa novorojenčka v enoti intenzivne terapije = Sepsis in newborns in intensive care unit

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  • "Sepsis in newborns in intensive care unit"@sl

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  • "Sepsis is one of the main reasons of morbidity and mortality in newborn and especially in prematurely born. With increased survival in very prematurely born, increase treatment intensity and with usage of broad-spectrum antibiotics change in sepsis causative agents is expected. Antibiotic sensitivity in late onset sepsis is expected. Intrapartal usage of antibiotics has increased, hence change in causative agents of early onset sepsis is expected. Patients and methods: Positive haemocultural overview of newborns treated in Clinical department of Paediatrics Maribor in the years 2000 through 2004 has been conducted. Sepsis has been divided in early onset (first 48 hours) and late onset (48 hours after admittance). Positive haemoculture newborns have been divided into 2 groups: (1) haemoculture contamination or transient bacteriemia if patient had no clinical and no biochemical inflammation signs and (2) sepsis, if patient had positive haemoculture with clinical and biochemical inflammation signs. Amongst treated newborns those with clinical sepsis who had clinical and biochemical inflammation response but negative haemoculture have been identified. Reuslts: In the years 2000 through 2004, 939 newborns have been treated, amongst those 498 needed intensive care. Amongst 70 newborns who were septic 121 positive haemocultures were found. Documentation overview found only 100 septic episodes, 21 haemocultures were contaminated. 50 patients had early onset sepsis, amongst them 24 had clinical sepsis, 26 had also positive haemoculture. 79 newborns had late onset sepsis, in 5 cases no causative agent was found. 14 patients died of sepsis. Overall mortality in septic newborn was 11,5 %, 14 % in early onset and 9 % in late onset sepsis. Conclusion: Sepsis is still and important cause of morbidity and mortality in newborns. Although survival of very prematurely born increased, mortality because of sepsis did not change."@sl
  • "Izhodišče: Sepsa je še vedno eden poglavitnih vzrokov obolevanja in umrljivosti pri novorojenčkih, oziroma nedonošenčkih. Z večjim preživetjem zelo nedonošenih novorojenčkov, povečano intenzivnostjo dela in uporabo večjega števila antibiotikov lahko pričakujemo spremembo povzročiteljev sepse in občutljivosti bakterij zlasti kasne sepse. Povečala se je tudi predrojstvena profilaktična uporaba antibiotikov, zato pričakujemo spremembe tudi pri zgodnji sepsi. Preiskovanci in metode dela: Opravili smo pregled pozitivnih hemokultur novorojenčkov zdravljenih na Kliničnem oddelku za pediatrijo, Odsek za intenzivno nego in terapijo, ki so bili rojeni v letih 2000 do 2004. Okužbe smo razdelili v zgodnje (od rojstva do 48 ur starosti) in kasne (po 48 urah starosti). Novorojenčke s pozitivnimi hemokulturami smo uvrstili v dve skupini: kontaminacija ali prehodna bakteriemija, če bolnik ni imel kliničnih niti biokemičnih kazalcev vnetja in sepsa, kjer so bili poleg pozitivne hemokulture prisotni biokemični ali klinični znaki sepse ali oboje. Med vsemi sprejetimi novorojenčki smo poiskali tudi tiste, kjer je bila na osnovi kliničnih in biokemičnih znakov postavljena diagnoza klinična sepsa, hemokultura pa je bila sterilna. Rezultati: Od leta 2000 do 2004 smo na Kliničnem oddelku za pediatrijo, Odsek za intenzivno nego in terapijo zdravili 939 novorojenčkov, od teh je bilo kritično bolnih 498. Vseh pozitivnih hemokultur je bilo 121, za sepso pa je zbolelo 70 otrok. Pregled dokumentacije je pokazal, da si bili le v stotih epizodah sepse prisotni tudi biokemični ali klinični znaki sepse ali oboje, 21 hemokultur pa je bilo kontaminiranih. Zgodnjo sepso je imelo 50 otrok, od tega 24 klinično sepso, 26pa tudi izoliranega povzročitelja. Kasno sepso je imelo 79 otrok, pri petih povzročitelja nismo izolirali. Septično stanje je povzročilo smrt pri 14 otrocih. Celokupna umrljivost septičnih novorojencev je bila 11,5 %, med zgodnjimi 14 %, med kasnimi pa 9 %. Zaključek: Sepse še vedno predstavljajo pomemben delež obolevanja novorojenčkov, umrljivost pa se glede na nižjo gestacijo obolelih ni povečala."@sl

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  • "Sepsa novorojenčka v enoti intenzivne terapije = Sepsis in newborns in intensive care unit"@sl

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