Risk factors associated with the type of bacterial sepsis in premature newborns in the NICU of the Teodoro Maldonado Carbo Hospital. A relational study

Abstract

Introduction: Neonatal bacterial sepsis is a severe systemic infection and a major cause of neonatal morbidity and mortality. In Ecuador, it ranked as the third leading cause of infant morbidity and accounted for 10% of neonatal deaths according to INEC (2019). Methods: This study aimed to analyze risk factors associated with bacterial sepsis in preterm neonates admitted to the Neonatal Intensive Care Unit of the Hospital de Especialidades Teodoro Maldonado Carbo between January 2021 and December 2022. A retrospective, cross-sectional, observational, and relational study was conducted, including 163 preterm neonates with clinical or confirmed bacterial sepsis. Neonatal and maternal variables, blood culture results, and hospital discharge outcomes (alive/deceased) were evaluated. Results: Blood cultures were negative in 128 cases (78.5%), and the most frequent pathogen was Klebsiella pneumoniae (68.97%). Significant associations were found with gestational age (p=0.016), 5-minute Apgar score (p=0.035), and maternal eclampsia (p=0.022). Overall mortality was 8.59%, with significantly higher mortality in late-onset sepsis (26%). In these cases, prolonged orotracheal intubation, central venous catheter use, and respiratory distress syndrome was significantly associated with death (p < 0.05). Conclusions: Bacterial sepsis is significantly associated with specific neonatal and maternal risk factors, and in late-onset sepsis, mortality is influenced by late neonatal risk factors, highlighting the importance of timely management of ventilatory support and invasive devices to improve survival in preterm neonates.