Clinical features and prognostic factors of early-onset sepsis: a 7.5-year experience in one neonatal intensive care unit.
- Author:
Se Jin KIM
1
;
Ga Eun KIM
;
Jae Hyun PARK
;
Sang Lak LEE
;
Chun Soo KIM
Author Information
- Publication Type:Original Article
- Keywords: Early-onset sepsis; Clinical features; Prognosis; Neonatal intensive care unit
- MeSH: Birth Weight; Escherichia coli; Gestational Age; Gram-Negative Bacterial Infections; Humans; Infant; Infant, Newborn; Infant, Premature; Intensive Care, Neonatal*; Medical Records; Mortality; Neutropenia; Prognosis; Retrospective Studies; Sepsis*; Streptococcus
- From:Korean Journal of Pediatrics 2019;62(1):36-41
- CountryRepublic of Korea
- Language:English
- 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.
