A Clinical Study of Sepsis with Thrombocytopenia in Premature Infants.
- Author:
Jae Hoon SIM
1
;
So Ick JANG
;
Yun Jung SIM
;
Do Jun CHO
;
Dug Ha KIM
;
Ki Sik MIN
;
Ki Yang YOO
Author Information
1. Department of Pediatrics, College of Medicine, Hallym University, Chunchon, Korea. dougkim@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Premature infant;
Sepsis;
Thrombocytopenia
- MeSH:
Blood Platelets;
Candida;
Diagnosis;
Female;
Gestational Age;
Gram-Negative Bacteria;
Heart;
Humans;
Incidence;
Infant;
Infant, Low Birth Weight;
Infant, Newborn;
Infant, Premature*;
Intensive Care, Neonatal;
Length of Stay;
Male;
Medical Records;
Mortality;
Neutropenia;
Platelet Count;
Retrospective Studies;
Risk Factors;
Sepsis*;
Thrombocytopenia*
- From:Korean Journal of Pediatrics
2004;47(10):1058-1064
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was performed to characterize sepsis with thrombocytopenia in premature infants to determine if thrombocytopenia is a prognostic factor in sepsis in premature infants. METHODS: We retrospectively analyzed the medical records of sepsis in premature infants admitted to the neonatal intensive care unit(N=41) at the Hallym University Sacred Heart Hospital from January 1999 to December 2002. The incidence, risk factors, symptoms, hematologic and bacteriologic findings were analyzed during episodes of sepsis. RESULTS: Of the 41 cases, 29(72%) were associated with thrombocytopenia. The ratio of male to female was 1.2 : 1. The vast majority(98%) were late-onset sepsis. The risk factors of the thrombocytopenic group were low birth weight and low gestational age. Major symptoms were poor activity (72%), apnea/tachypnea(52%), but were not significantly different between two groups. In the thrombocytopenic group(N=29), low total WBC count and high CRP level were discovered(P=0.03, P<0.01). The mean platelet count was 70.17(x103/mm3) at diagnosis of sepsis, and a mean platelet nadir was 43.10(x103/mm3). The severe thrombocytopenia(below 50x103/mm3) in the thrombocytopenic group was discovered in 69% and the duration of thrombocytopenia was about eight days. The majority of pathogens were gram-negative bacteria and candida. The thrombocytopenic group showed a pro longed length of stay and a high mortality rate. According to comparisons between the survived and expired groups, low birth weight, low gestational age, neutropenia and thrombocytopenia were significantly correlated with mortality(P<0.05). CONCLUSION: The sepsis with thrombocytopenia in premature infants showed late-onset sepsis and high morbidity and mortality, although differences were not significant statistically. Especially, low birth weight and low gestational aged infants should be cautiously treated and monitored.
