RISK FACTORS FOR MORTALITY IN PATIENTS WITH LATE-ONSET NEONATAL SEPSIS AT THE INSTITUTO NACIONAL MATERNO PERINATAL IN LIMA, PERU, 2023–2024

Dávila Aliaga C.R.; Mendoza Ibañez E.; Torres Marcos E.; Paucar Zegarra R.; Campaña-Acuña A.; Saldaña Díaz C.V.; Hinojosa Pérez J.R. · Revista de la Facultad de Medicina Humana (2025) · DOI: 10.25176/rfmh.v25i4.7858

Resumen

Introduction: Late-onset neonatal sepsis (LONS) is a frequent and potentially fatal nosocomial infection in hospitalized preterm neonates. Objectives: To identify risk factors for mortality in LONS confirmed by blood culture at the Instituto Nacional Materno Perinatal (INMP), 2023–2024. Methods: A retrospective cohort study with survival analysis was conducted. A total of 161 neonates with LONS were included. The unit of analysis was each episode (188 episodes). Variables included neonatal characteristics, use of invasive devices, invasive respiratory support, and acid-base parameters. Cox regression with robust variance was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Results: The incidence of confirmed LONS was 73.8 per 1,000 hospitalized neonates and 10.9 per 1,000 live births, with a mortality rate of 19.3% (31/161). Neonates who died required more invasive respiratory support (p = 0.005) and had lower pH and bicarbonate levels, reflecting greater acid-base imbalance. Metabolic acidosis was associated with a higher risk of death in the adjusted model (adjusted HR 2.44; 95% CI 1.17–5.10; p = 0.018). Gram-positive organisms predominated, particularly Staphylococcus haemolyticus and coagulase-negative Staphylococcus; among Gram-negative organisms, Klebsiella pneumoniae was the most frequent isolate. Conclusion: Metabolic acidosis was independently associated with mortality. These findings underscore the importance of early identification of metabolic disturbances and microbiological surveillance in neonatal units. © Article published by the Revista de la Facultad de Medicina Humana of Universidad Ricardo Palma. It is an open access article, distributed under the terms of the Creative Commons License: Creative Commons Attribution 4.0 International, CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/), which allows non-commercial use, distribution and reproduction in any medium, provided that the original work is duly cited.

Instituciones: Universidad Privada Norbert Wiener