Factors associated with late-onset sepsis in neonates admitted to a Neonatal Intensive Care Unit in Southern Brazil

Abstract

Background and Objectives: Late-onset neonatal sepsis is one of the main healthcare-associated infections affecting newborns admitted to neonatal intensive care units, with high incidence rates and a significant impact on neonatal morbidity and mortality. The objective of the study was to analyze factors associated with the development of late-onset sepsis in newborns admitted to neonatal intensive care units (NICUs). Methods: Retrospective documentary cohort study. Data were collected from the medical records and discharge summaries of neonates admitted to the NICU from January 2016 to December 2020 at a philanthropic general hospital in the northwestern region of the state of Rio Grande do Sul, Brazil. The data were analyzed using descriptive, analytical, and inferential statistics. Results: Late-onset sepsis occurred in 34% of the 494 newborns included in the study. The mean age at diagnosis of late-onset sepsis was 10 days; 52.9% of blood cultures were positive. Late-onset sepsis was associated with a lower number of prenatal appointments (p = 0.003), gestational age and prematurity (p = 0.001), complications during pregnancy (p = 0.001), blood transfusion (p < 0.001), corticosteroid use (p = 0.02), resuscitation at birth (p = 0.01), and very low birth weight (p = 0.001). Conclusion: The incidence of late-onset sepsis in the NICU was high compared with rates reported in the literature. Developing strategies to reduce these rates is necessary, focusing on the quality of care and prevention measures while considering the different risk factors present during the hospitalization and hospital stay of newborns.