Perfil das infecções neonatais em recém- nascidos prematuros com displasia broncopulmonar em uma unidade de terapia intensiva neonatal.

Abstract

Introduction: Neonatal infections remain one of the leading causes of morbidity and mortality in neonatal intensive care units, especially among premature newborns with bronchopulmonary dysplasia. Bronchopulmonary dysplasia is a multifactorial chronic lung disease resulting from interactions between pulmonary immaturity, inflammatory processes, and postnatal exposures such as mechanical ventilation and infection. Objective: To analyze the profile of neonatal infections in preterm newborns with bronchopulmonary dysplasia in the neonatal intensive care unit of a university reference hospital in Goiânia, Goiás. Method: This is a quantitative, descriptive, retrospective study conducted from January 2019 to July 2025, based on the review of 85 medical records of preterm newborns with gestational age under 34 weeks diagnosed with neonatal infection and bronchopulmonary dysplasia. Data were collected from clinical records. Results: Among the 85 participants, 31% presented early-onset neonatal infection, 19% late-onset infection, and 50% both types. A total of 80 episodes of lateonset infection were recorded, with bloodstream infections (34%) and meningitis (19%) being the most frequent. The most commonly isolated microorganisms were methicillin-resistant Staphylococcus aureus, Staphylococcus haemolyticus, Klebsiella pneumoniae, and Staphylococcus epidermidis, reflecting the predominance of pathogens associated with invasive devices and hospital care. Among newborns who developed bronchopulmonary dysplasia and neonatal infection, 44% had an Apgar score lower than 7 at the first minute of life. Additionally, 59% required neonatal resuscitation, 46% underwent invasive mechanical ventilation, 49% received Continuous Positive Airway Pressure, and 64% used surfactant, indicating greater initial clinical severity and the need for early respiratory support. Bronchopulmonary dysplasia was classified as mild in 34%, moderate in 37%, and severe in 29% of the preterm infants. Very low and extremely low birth weight newborns predominated, with high use of mechanical ventilation (79%), parenteral nutrition (96%), and a mean length of hospital stay of 57 days (±33.4). The mortality rate was 13%. Conclusion: The study described the profile of neonatal infections in preterm newborns with bronchopulmonary dysplasia, highlighting clinical, microbiological, and healthcare-related characteristics observed in the analyzed sample. The infections identified reflected the care context of the unit, with no inferential comparisons or risk assumptions in relation to groups not investigated. The presence of multidrug-resistant pathogens and the prolonged use of invasive devices underscore the need for strict prevention measures. The findings contribute to a comprehensive characterization of the target population, providing a basis for optimizing neonatal care and reinforcing patient safety protocols within intensive care settings.