Journal of the Korean Pediatric Society 1993;36(1):49-56.
Published online January 15, 1993.
A Clinical Study on Early Diagnosis in Neonatal Sepsis
Jong Kwang Lee, Hae Won Cheon, Jee Hee Park, Jung Hwa Lee, Joo Won Lee, Soon Kyum Kim
Department of Pediatircs, College of Medicine, Korea University, Seoul, Korea
신생아 패혈증의 조기 진단다에 대한 임상적 고찰
이종광, 전혜원, 박지희, 이정화, 이주원, 김순겸
고려대학교 의과대학 소아과학교실
Abstract
Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newborn and its successful outcome depends on early detection and prompt institution of an effective antimicrobial therapy. Accurate diagnosis of the neonatal septicemia, however, is quite difficult because its early signs and symptoms are rather subtle. This study was conducted in an attempt to search for useful early markers for the clinical entity. A total of 224 newborns, over a 17-month period (1/90-5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory parameters that showed highest correlation with bacteriologically proves sepsis were as follows: Total WBC counts(<5,000/mm3), Band/Total neutrophils(0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml). Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures (positive predictive value: 29%), Only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures (false negative:2%). It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.
Key Words: Neonatal Sepsis, Early diagnosis


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