Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit

  • Kim, Se Jin (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Ga Eun (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Park, Jae Hyun (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Lee, Sang Lak (Department of Pediatrics, Keimyung University School of Medicine) ;
  • Kim, Chun Soo (Department of Pediatrics, Keimyung University School of Medicine)
  • Received : 2018.07.26
  • Accepted : 2018.09.27
  • Published : 2019.01.15
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Abstract

Purpose: In this study, we investigated the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis was conducted on medical records from January 2010 to June 2017 (7.5 years) of a university hospital NICU. Results: There were 45 cases of EOS (1.2%) in 3,862 infants. The most common pathogen responsible for EOS was group B Streptococcus (GBS), implicated in 10 cases (22.2%), followed by Escherichia coli, implicated in 9 cases (20%). The frequency of gram-positive sepsis was higher in term than in preterm infants, whereas 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 were significant differences 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. After adjustments based on the difference in gestational age and birth weight between the 2 groups, gram-negative pathogens (odds ratio [OR], 42; 95% confidence interval [CI], 1.4-1,281.8) and some clinical findings, such as neutropenia (OR, 46; 95% CI, 1.3-1,628.7) and decreased activity (OR, 34; 95% CI, 1.8-633.4), were found to be associated with fatality. Conclusion: The common pathogens found to be responsible for EOS in NICU patients are GBS and E. coli. Gram-negative bacterial infections, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.

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References

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