Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit

Kim, Se Jin; Kim, Ga Eun; Park, Jae Hyun; Lee, Sang Lak; Kim, Chun Soo

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자료유형: 학술저널

저자정보: 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)

저널정보: 대한소아청소년과학회 Korean journal of pediatrics Korean journal of pediatrics 제62권 제1호

발행연도: 2019.1

수록면: 36 - 41 (6page)

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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.

#Early-onset sepsis #Clinical features #Prognosis #Neonatal intensive care unit

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