Clinical features and prognostic factors of early phase of infection in newborn infants with early-onset sepsis
- Author(s)
- Se Jin Kim; Ga Eun Kim; Jae Hyun Park; Sang Lak Lee; Chun Soo Kim
- Keimyung Author(s)
- Lee, Sang Lak; Kim, Chun Soo; Park, Jae Hyun
- Department
- Dept. of Pediatrics (소아청소년학)
- Journal Title
- Korean Journal of Pediatrics
- Issued Date
- 2018
- Volume
- 27
- Issue
- 9
- Keyword
- Early-onset sepsis; Clinical features; Prognosis; Neonatal intensive care unit
- Abstract
- Purpose: This study was undertaken to investigate the clinical features and prognostic factors
of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients.
Methods: A retrospective analysis of the medical records was conducted in a NICU of a
university hospital over a 7.5-year period (Jan 2010-Jun 2017).
Results: During the study period, there were 45 (1.2%) episodes of EOS in 3,862 infants.
The most common pathogen responsible for EOS was Streptococcus group B (GBS) in 10
cases (22.2%), followed by E. coli in 9 cases (20%). The frequency of Gram-positive sepsis
was higher in term than in preterm infants, while the rate of Gram-negative infection was higher
in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47%
of deaths occurred within the first 3 days of infection. There was a significant difference in
terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g)
between the death and survival groups. In a comparison after adjusting for the difference in
gestational age and birth weight between the two groups, Gram-negative pathogens (OR: 42,
95% CI: 1.4~1281.8) and some clinical findings, such as neutropenia (OR: 46, 95% CI:
1.3~1628.7) and decreased activity (OR: 34, 95% CI: 1.8~633.4), were associated with
fatality.
Conclusion: The common pathogens responsible for EOS in NICU patients are GBS and E.
coli. Infection caused by Gram-negative bacteria, decreased activity in the early phase of
infection, and neutropenia were associated with poor outcomes.
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