EPIDEMIOLOGICAL FEATURES OF NEONATAL SEPSIS IN THE RUSSIAN FEDERATION AND WORLD

  • Authors: Gomanova L.I.1, Sytaya J.S.1
  • Affiliations:
    1. First Moscow I.M. Sechenov State Medical University (Sechenov University) Russia, Moscow
  • Issue: Vol 10 (2021): Материалы XVII Международной Бурденковской научной конференции 22-24 апреля 2021 года
  • Pages: 175-178
  • Section: Инфекционные болезни и иммунология
  • URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/6362

Cite item

Abstract

Relevance. Neonatal sepsis is a systemic infection associated with inflammation and life-threatening organ dysfunction. It remains the leading cause of morbidity and mortality among newborns, especially in middle and low-income countries. According to modern data, more than 3 million newborns suffer from sepsis every year in the world. Neonatal sepsis is still difficult to diagnose due to its non-specific signs and symptoms. Health care-related infections (HAIs) and drug resistance remain important issues for sepsis.
Purpose. Summarize and analyze the epidemiological features of neonatal sepsis in the Russian Federation and the world, highlight the problems regarding sepsis in newborns.
Materials and methods. In the course of scientific work, the data of the State. reports on the sanitary and epidemiological well-being of the population of the Russian Federation for 2018-2019; data of statistical materials of Medico-demographic compilations of the Russian Federation for 2009-2018. Rosstat (table 4.85); and also summarized the data of scientific foreign and domestic literature of recent years from the Pubmed and eLibrary databases on the epidemiology of neonatal sepsis.
Results. Mortality from sepsis among newborns for the period from 2009 to 2015 in the Russian Federation had an upward trend, however, since 2016, there has been a downward trend. In 2009, 369 newborns died from bacterial sepsis (21.0 per 100 thousand live births), but in 2015, sepsis led to the death of 688 newborns (35.5 per 100 thousand live births). Then the number of newborns who died from sepsis began to decrease from 652 (34.5 per 100 thousand children born alive) in 2016 to 536 (33.4 per 100 thousand children born alive) in 2018.According to WHO, neonatal sepsis is the third largest the frequency of the cause of neonatal mortality. Globally, neonatal mortality has shown a declining trend over the past 20 years, from 50.6 per 1000 live births in 1998 to 28.9 per 1000 live births in 2017.
Conclusion. Neonatal sepsis remains an important public health problem, as it leads to severe consequences for newborns (multiple organ failure, distress syndrome, coma, mental retardation). Infectious diseases of the mother, unjustified use of antibacterial drugs, catheter-associated infections, premature birth, low birth weight are factors contributing to the development of neonatal sepsis. Modern epidemiological data prove that with proper preventive measures, these risk factors can be minimized, which will positively affect the quality of life of newborns.

Full Text

Relevance. The neonatal period is the most vulnerable period in the life of every newborn. Globally, about 4 million children die each year in the first 4 weeks of life, of which 99% of deaths occur in low- and middle-income countries and 75% of which are considered preventable. According In OZ neonatal sepsis is the third most common cause of neonatal mortality [ ]. E zhegodno recorded over 3 million deaths from neonatal sepsis [ ]. Worldwide, neonatal sepsis occurs in approximately 1-50 newborns out of 1000 and accounts for 3-30% of infant and child mortality annually [ ]. Despite advances in the field of maternal and child health, neonatal medicine and maternal antibiotic prophylaxis (prevention of infections caused by Streptococcus th group Bed and ) , the incidence of neonatal sepsis remains high ( 1-4 per 1000 live births in the United States ) , and the mortality and disability affect up 40% of newborns with sepsis [ ].    

Purpose. To analyze the epidemiological situation regarding neonatal sepsis in the Russian Federation and in the world.

Materials and methods. The main method of study was to analyze the available e OF DATA State. report on the sanitary and epidemiological well-being of the population of the Russian Federation for 2018; data of statistical materials of Medico-demographic collections of the Russian Federation for 2009-2018. Rosstat (table 4.85); data of scientific foreign and domestic literature of recent years from the Pubmed and eLibrary databases .

Results. In the world of Mr. eonatalnaya mortality showed a downward trend over the past 20 years, from 50.6 per 1,000 live births in 1998 to 28.9 per 1,000 live births in 2017. H In spite of this neonatal sepsis remains the main cause of neonatal mortality due to a high risk of infection because the immune system in immature active period [ ]. For the most common pathogens associated with the development of neonatal sepsis , include Staphylococcus aureus , Streptococcus pneumoniae , Streptococcus pyogenes , Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa , Salmonella typhi , and echovirus, enterovirus, parehovirus, adenovirus, parainfluenza virus, rhinovirus, herpes simplex herpes and others. Candida albicans is the most common fungal agent associated with the development of neonatal sepsis [ ]. The main source of opportunistic microflora is bacteria in the birth canal of a pregnant woman. The annual incidence of neonatal sepsis is 2,220 per 100,000 live births, and this figure is likely to increase in low- and middle-income countries. For example, India has the highest incidence of sepsis ( 17,000 per 100,000 live births). Mortality from neonatal sepsis in India ranges from 25% to 65% [ ]. In 2013, 38.9% of neonatal sepsis-related deaths occurred in South Asia [ ].                

In the Russian Federation, according to Shchegolev and A.I. et al., in 2010 ode neonatal sepsis was the primary cause of death in 104 n ovorozhdennyh, representing 2.1 % of all cases of early- th neonatal death. In 2014, neonatal sepsis as the main disease was noted in 219 deceased newborns (4.06%) [ ] . In accordance with statistical data from the Medico-demographic compilations of the Russian Federation (table 4.85 "Mortality of children from certain conditions arising in the perinatal period ") in 2018, in the territory of the Russian Federation, bacterial sepsis of newborns caused death in 536 newborns, which was 33.4 per 100 thousands of children born alive. The proportion of sepsis among the causes of death in newborns was 13.1%. In 2017, 646 newborns died from sepsis. In 2016, 652 newborns died of bacterial sepsis (34.5 per 100 thousand live births). For 2009-2018 the highest mortality rate from sepsis among newborns was in 2017 - 38.2 per 100 thousand children born alive. The lowest rate was observed in 2010 - 325 newborns died from bacterial sepsis (18.2 per 100 thousand children born alive). In accordance with the data of the State Report on Sanitary and Epidemiological Well-being for 2018, the number of purulent-septic infections (PSI) among newborns decreased, compared to 2008, 1.6 times (in 2018, 2,884 cases of PSI of newborns were registered, in 2008 - 4 696). In the nosological structure of neonatal morbidity, the importance of generalized forms, such as sepsis, is increasing, which accounted for 9.1% in 2018 against 3% in 2008. Mortality from generalized forms of GSI in newborns remains stable and amounted to 6.8 in 2018 % (in 2008 - 7%), which indicates incomplete accounting and registration of localized forms of GSI. In accordance with the data of the State Report on Sanitary and Epidemiological Well-being for 2019 , 2,555 cases of GSI newborns were registered , which is 329 less cases compared to the data for 2018. Recently, intrauterine infections of newborns (IUIs), the number of which many times exceed the number of IUIs of newborns, have become very important. This may indicate a possible concealment of cases of nosocomial purulent-septic infection in newborns diagnosed with intrauterine infection or overdiagnosis of IUI.

Discussion. In the Russian Federation, an emerging trend towards a decrease in mortality from sepsis in 2015-2018 . among newborns, it can indirectly speak of improving diagnostics and sepsis, conducting rational antibacterial therapy, increasing control of disinfection and sterilization measures in the medical institution . Do not forget that particular problems for modern medicine are infections associated with the provision of medical care (HAI) and drug resistance to certain strains of microorganisms . With respect to neonatal sepsis, these issues require immediate solutions in the form of increase I the effectiveness of ongoing laboratory and instrumental research , development and implementation of new laboratory methods for detection of resistance of pathogens to IHS antibiotics.

Conclusion. Neonatal sepsis warrants further study due to high morbidity and mortality worldwide . There is a need to develop highly effective and affordable diagnostic methods, as this pathology is especially relevant for countries with middle and low income. Timely diagnosis of neonatal sepsis is critical to prevent the deterioration of the clinical picture, reduce mortality and prevent the appointment of irrational antibiotic therapy. It is necessary to increase the efficiency of laboratory and instrumental studies, including the control of disinfection and sterilization measures in medical institutions , the development and implementation of new methods for the prevention of neonatal sepsis. These activities must be carried out in a comprehensive manner by examining the mother-child pair.  

×

About the authors

Liliya Ilinichna Gomanova

First Moscow I.M. Sechenov State Medical University (Sechenov University)
Russia, Moscow

Author for correspondence.
Email: gomanova_liliya@mail.ru
ORCID iD: 0000-0002-6713-7090
SPIN-code: 3832-2089
Russian Federation

Julia Sergeevna Sytaya

First Moscow I.M. Sechenov State Medical University (Sechenov University)
Russia, Moscow

Email: julia.98.med.university@mail.ru
ORCID iD: 0000-0003-2412-5329
SPIN-code: 9639-4310
Russian Federation

References

  1. Wattal C, Kler N, Oberoi JK, et al. Neonatal Sepsis: Mortality and Morbidity in Neonatal Sepsis due to Multidrug-Resistant (MDR) Organisms: Part 1. Indian J Pediatr. 2020;87(2):117-121. doi: 10.1007/s12098-019-03106-z
  2. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223-230. doi: 10.1016/S2213-2600(18)30063-8
  3. Ershad M, Mostafa A, Dela Cruz M, et al. Neonatal Sepsis. Curr Emerg Hosp Med Rep. 2019;7(3):83-90. doi: 10.1007/s40138-019-00188-z
  4. Butt WW, Chiletti R. ECMO for Neonatal Sepsis in 2019. Front Pediatr. 2020;8:50. doi: 10.3389/fped.2020.00050
  5. Assemie MA, Alene M, Yismaw L, et al. Prevalence of Neonatal Sepsis in Ethiopia: A Systematic Review and Meta-Analysis. Int J Pediatr. 2020;2020:6468492. doi: 10.1155/2020/6468492
  6. Murthy S, Godinho MA, Guddattu V, et al. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PLoS One. 2019;14(4):e0215683. doi: 10.1371/journal.pone.0215683
  7. Chaurasia S, Sivanandan S, Agarwal R, et al. Neonatal sepsis in South Asia: huge burden and spiralling antimicrobial resistance. BMJ. 2019;364:k5314. doi: 10.1136/bmj.k5314
  8. Щеголев А.И., Мишнёв О.Д., Туманова У.Н., и др. Неонатальный сепсис как причина перинатальной смертности в российской федерации // Международный журнал прикладных и фундаментальных исследований. – 2016. – № 5-4. – С. 589-594
  9. [Shchegolev A.I., Mishnev O.D., Tumanova U.N., et al. Neonatal sepsis as a cause of perinatal mortality in the Russian Federation // International journal of applied and fundamental research – 2016. – № 5-4. – P. 589-594]

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies