Faculty of Medicine

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    THE INCIDENCE OF NEONATAL SEPSIS AT A TERTIARY NEONATAL INTENSIVE CARE UNIT (A 9 MONTHS SURVEY)
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, "Ss. Cyril and Methodius"University, R.N.Macedonia, 2021-10-03)
    ;
    Bushinoska Jasna
    ;
    Orovchanec Nikola
    ABSTRACT Introduction: Neonatal sepsis is severe infection that affect newborns in the first 28 days of live. The first 28 days of life of newborns are the most vulnerable period in life of newborns, known as neonatal period of live. Newborns may be infected before, during or after the birth. Neonatal sepsis as a blood stream infection could be presented like pneumonia, pyelonephritis, gastroenteritis, osteomyelitis, arthritis or meningitis in newborns. Neonatal sepsis can be diag nosed by clinical signs of sepsis or with a positive microbiological culture-culture proven sepsis. Research Purpose: The purpose of this study is to show the incidence of neonatal sepsis, neonatal mortality caused by sepsis in early and late neonatal period, and the most common bacterial triggers of neonatal sepsis in the given period, among live-born newborns at the GOC Skopje, treated at NICU in the first 28 days after delivery. Material and Methods: This prospective analysis elaborates on incidence of neonatal sepsis, neonatal mortality caused by sepsis and the most common bacterial triggers of neonatal sepsis in live-born neonates in the first 28 days after delivery at the GOC-Skopje, in the period 01.05.2019-31.01.2020. The data is collected from the Data basis at NICU and the medical his tories of women that gave birth and the histories of newborns at GOC-Skopje, during this period. Results: During this period of 9 months at GOC-Skopje, there were 3,453 live-born new borns, out of which 445 newborns were transferred and treated at NICU. 124 of these newborns, developed clinically and laboratory signs of neonatal sepsis, or 36 on 1000 live-births. 32 (25.8%) of newborns which developed neonatal sepsis, died in neonatal period or 9 on 1000 live-births. The most common bacterial cause for neonatal sepsis were Klebsiella pneumoniae, followed by Staphylococcus aureus, Enterobacter species, Serratia marcescens and Escherichia coli. Conclusion: The hospital neonatal sepsis and mortality from neonatal sepsis at GOC-Skopje is quite higher than in the developed countries of the world.
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    Neonatal mortality rate at Gynecology and Obstetrics Clinic in Skopje in the period of five years in newborns treated at Neonatal Intensive Care Unit
    ("Ss. Cyril and Methodius" University, Faculty of Medicine, Department of Anaesthesia and Reanimation, 2020-10)
    ;
    Bushinoska J
    ;
    Orovcanec N
    Introduction: Neonatal mortality is a number of neonatal deaths per 1,000 live births in a given year or period. Neonatal mortality is defned as a death in the frst 28 days of life or a neonatal period after delivery. It includes all life born neonates after 22 gestational week of pregnancy and with birth weight over 500 g. Neonatal mortality is divided into early neonatal mortality which count deaths in 0-7 days after delivery, and late neonatal mortality 8-28 days after delivery. AIM: The aim of the study is to present hospital neonatal mortality rate at the GOC-Skopje, among newborns treated at NICU in the neonatal period of 0-28 days after births, in the period of fve years 2013-2017 and to determinate the leading causes of neonatal deaths at NICU. Material and Methods: Retrospective study counts neonatal mortality rate in the early and late neonatal period, as well as the leading causes for neonatal deaths in neonatal period of 0-28 days after delivery at the GOC-Skopje, in the period of 5 years. The data is collected from the Data basis of NICU at GOC-Skopje. Results: Hospital neonatal mortality rate in the 5 years period was 25.6‰, or 25.6 neonatal deaths in the neonatal period. There were 688 neonatal deaths on 26,891 live-born neonates. Neonatal mortality rate in early neonatal period (0-7 days) is – 547 or 20.34‰ of all neonatal deaths in the fve years period. Late neonatal mortality (8-28 days) after delivery was in 141 casesor 5.24‰. The leading causes for neonatal death in newborns treated at NICU were com plications due to prematurity, respiratory distress syndrome and neonatal sepsis. Conclusion: The hospital neonatal mortality rate at GOC-Skopje in fve years period is high, and requires more prospective studies and strategies to reduce neonatal mortality in the future.
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    Meconium aspiration syndrome-significant problem in the NICU
    (Здружение на физиолози и антрополози на Македонија, 2018)
    Background: The aim of this study was to evaluate and describe the course of perinatal and postnatal factors in neonates with meconium aspiration syndrome (MAS) to determine the risk factors for the degree of disease and to determine the correlation on duration of mechanical ventilation, NICU stay and duration of antibiotic treatement.. Methods: According the gestational age and severity of condition, respiratory distress and hypoxia of the infants we included 32 infants divided into two groups: first preterm group of gestational age < 37 weeks, and second group term infants of gestational age > 37 weeks. The correlation between gestational age and need of conventional mecanical ventilation, duration of NICU stay and duration of antibiotic therapy was monitored. Results: In this study were included 32/185 infants admissioned at our tertiary care department from 2015 to 2017 with clinical symptoms of tachypnea, respiratory distress and hypoxia. In both groups, we confirmed the correlation between gestational age and duration of MV, NICU stay, more emphasized in the second group In the first group duration of mechanical ventilation was ( 7,25 days, p < 0,01 ), duration of NICU stay ( 9,5 days, p < 0,01). In the second group duration of mechanical ventilation was ( 9,4 days, p < 0,01 ), duration of NICU stay ( 10,3 days, p < 0,01). Use of antibiotic therapy did not result in significant reduction in the risk of mortality, sepsis or duration of hospital stay in both groups ( 10,3 days, p = 0,1; 10,7 days, p = 0,1). Conclusion: Meconium aspiration syndrome (MAS) is a common cause of respiratory failure in neonates. Despite improvement in obstetrical and neonatal care, MAS continues to be a neonatal disorder with high morbidity and mortality.