Протокол наблюдения, обследования и антибактериальной терапии новорожденных с подозреваемой и/или подтвержденной неонатальной инфекцией

Обоснование. Одной из причин ранней неонатальной смерти в России и мире является инфекция. В течение последних лет в нашей стране инфекционный диагноз в 16–25% случаев являлся основным среди новорожденных, умерших в первые 168 ч жизни. По данным популяционных исследований разных стран, совокупная заболеваемость неонатальным сепсисом составляет 22 случая на 1000 живорожденных детей, а смертность — от 11 до 19%. Своевременная диагностика и назначение этиотропного лечения, в большинстве случаев антибактериальной терапии (АБТ), имеют решающее значение в исходе неонатальной инфекции. Однако в Российской Федерации, как и в большинстве других стран, отсутствуют единые протоколы и клинические рекомендации по данному вопросу. Таким образом, единственным решением данной проблемы является создание локальных протоколов, основанных на современной доказательной базе и в то же время соответствующих микробной флоре и материально-техническим возможностям конкретной медицинской организации. В статье представлен локальный протокол Екатеринбургского клинического перинатального центра (ЕКПЦ) «Протокол наблюдения, обследования и АБТ новорожденных с подозреваемой и/или подтвержденной неонатальной инфекцией», разработанный сотрудниками ЕКПЦ с учетом международных согласительных документов, данных рандомизированных клинических исследований и метаанализов, а также специфик перинатального центра.

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