CHARACTERISTICS OF GRAM-NEGATIVE NEONATAL SEPSIS AND ASSOCIATED RISK FACTORS AT BACH MAI HOSPITAL
Nội dung chính của bài viết
Tóm tắt
Objective:
To describe the clinical and laboratory characteristics of Gram-negative neonatal infections and to identify risk factors associated with multidrug-resistant (MDR) Gram-negative infections at the Pediatric Center, Bach Mai Hospital, during 2023–2025.
Methods:
A cross-sectional study combined with a case–control design was conducted among neonates (<28 days old) diagnosed with neonatal sepsis. The case group included 60 infants with culture-confirmed MDR Gram-negative infections, and the control group consisted of 180 infants with negative cultures. Clinical manifestations, laboratory findings, and potential risk factors were collected and statistically analyzed.
Results:
Among 60 cases of Gram-negative neonatal infections, late-onset sepsis accounted for 78.9%, while early-onset sepsis accounted for 21.1%. Klebsiella pneumoniae was the most common pathogen (42.3%). The predominant clinical features were respiratory distress (83.3%), tachypnea ≥60 breaths/min (75%), chest retraction (73.3%), SpO₂ <90% (56.7%), poor feeding (56.7%), and jaundice (35%). Laboratory abnormalities included leukocytosis (43.3%), thrombocytopenia (40%), hypoalbuminemia (66.7%), elevated CRP (78.3%), and coagulopathy(70%).
Significant risk factors for MDR Gram-negative infection (p <0.05) included age at admission ≥7 days, late-onset sepsis, bag-mask ventilation or re-intubation, blood transfusion, parenteral nutrition, umbilical or central line catheterization, invasive mechanical ventilation ≥7 days, use of vasopressors, and exposure to ≥2 antibiotics or antibiotic regimen changes during treatment.
Conclusion:
Gram-negative neonatal infections, particularly those caused by Klebsiella pneumoniae, are common and mainly associated with late-onset sepsis. Respiratory symptoms predominate, often accompanied by hematologic, biochemical, and coagulation abnormalities. Early identification and close monitoring of high-risk neonates, adherence to aseptic techniques, effective infection control, and rational antibiotic use are essential to improve outcomes and reduce mortality.
Chi tiết bài viết
Từ khóa
Neonatal sepsis, Gram-negative bacteria, risk factors, multidrug resistance.
Tài liệu tham khảo
Dinh Thi Thuy Hoa. Analysis of antibiotic use in the treatment of multidrug-resistant Gram-negative infections at Dong Nai General Hospital. Vietnam Journal of Medicine. 2021;501(1).
Parmanik A, Das S, Kar B, Bose A, Dwivedi GR, Pandey MM. Current treatment strategies against multidrug-resistant bacteria: a review. Current Microbiology. 2022;79(12):388.
Tran Luong Nhan, Nguyen Thi Quynh Nga. Clinical and laboratory features of neonatal sepsis at the Neonatal Department, Hanoi Obstetrics and Gynecology Hospital. Vietnam Journal of Medicine. 2024;542(2).
Do Thi Huong Giang, Nguyen Thi Quynh Nga. Bacterial etiology of neonatal sepsis at the National Children’s Hospital. Vietnam Journal of Medicine. 2023;530(1B).
Ismail HM, Abd El Aziz A, El Araby H, Soliman WS. Risk factors assessment and clinical profile of neonatal sepsis in blood culture-proven neonates. Research Journal of Applied Biotechnology. 2019;5(1):99–109.
Duong QT, Thai SD, Ngoc ND, Thi THN. Treatment outcomes of neonatal sepsis at the Pediatric Center, Thai Nguyen Central Hospital. Vietnam Journal of Medicine. 2022;512(1).
Nguyen TNT, Nguyen PS, Le VK, Tran THN, Tran CL. Clinical and laboratory characteristics of preterm neonatal sepsis at Can Tho Children’s Hospital. Vietnam Journal of Medicine. 2025;547(2).
Thanh HTP, Anh TTK, Can NT. Clinical and laboratory features of neonatal sepsis in the Neonatal Intensive Care Unit, Nghe An Obstetrics and Pediatrics Hospital. Journal of 108 Clinical Medicine and Pharmacy. 2021.
Doan TTB, Phan VN, Pham TN, Nguyen TDT. Clinical and laboratory characteristics of neonatal sepsis at Nghe An Obstetrics and Pediatrics Hospital, 2022–2023. Vietnam Journal of Medicine. 2023;527(1B).