Infección de inicio tardío: vigilancia y control

Introduccion. Es objetivo de esta presentacion identificar la incidencia, principales indicadores epidemiologicos de riesgo, causas de ingreso, formas clinicas y germen de aislamiento mas frecuente en infecciones de inicio tardio, asi como caracterizar el grupo estudiado, de acuerdo con el peso y la madurez. Metodos. Se realizo una investigacion observacional, descriptiva y longitudinal en la que se incluyeron 187 neonatos con diagnostico de infeccion de inicio tardio, egresados del Servicio de Neonatologia del Hospital America Arias, entre el 2000 y el 2006. Resultados. Se presentaron 247 episodios de sepsis. La causa mas frecuente de ingreso fue el bajo peso al nacer (44,3 por ciento). Clasificaron como preterminos 97 ninos. La sepsis generalizada fue la manifestacion clinica mas frecuente (48,5 por ciento). El procedimiento mas empleado resulto el cateterismo epicutaneo (66,8 por ciento) y el germen mas aislado, el estafilococo coagulasa-positivo. Se observo aumento de la incidencia neta y por dispositivos. Conclusiones. La frecuencia de pacientes con infeccion de inicio tardio se ubico en el rango internacional. Las principales causas de ingreso fueron el bajo peso al nacer y el sindrome de dificultad respiratorio transitorio; la forma clinica de presentacion mas frecuente fue la sepsis generalizada, y el germen causal de mayor aislamiento, el estafilococo coagulasa-positivo. Hubo pacientes con mas de un episodio septico. El empleo de procedimientos resulto elevado. Se observo incremento tanto de la incidencia acumulada, como de la acumulada de pacientes infectados. Las tasas de infeccion mostraron comportamiento irregular y la tendencia lineal tendio a la disminucion. Introduction. The objective of this paper is to identify the incidence, main epidemiological indicators of risk, admission causes, clinical forms and the most frequent isolated germ in late onset infections, as well as to characterize the studied group, according to weight and maturity. Methods. An observational, descriptive and longitudinal research was conducted. 187 neonates with diagnosis of late onset infection that were discharged from the Neonatology Service of America Arias Hospital between 2000 and 2006 were included. Results. 247 episodes of sepsis were presented. The most common cause of admission was low birth weight (48.5 percent). 97 children were classified as preterm. Generalized sepsis was the most frequent clinical manifestation. The most used procedure was the epicutaneous catheterism (66.8 percent), and the most isolated germ was the positive-coagulase staphylococcus. An increase of the net incidence and of the incidence by devices was observed. Conclusions. The frequency of patients with late onset infection occupied an international place. The main causes of admission were low birth weight and the transient respiratory distress syndrome. The most common clinical form was the generalized sepsis, whereas the most isolated causal germ was the positive-coagulase staphylococcus. There were patients with more than one septic episode. The use of procedures was high. An increase was observed in the accumulated incidence and in the accumulated incidence of infected patients. The infection rates showed an irregular behaviour and the lineal trend tended towards decreasing.