| The Studies on Neonatal Septicemia |
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S.J. Kim, Y.J. Cho, S.J. Choi |
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Department of Pediatrics College of Medicinet Ewha Womens University |
| 新生兒 敗血症의 原因的 臨床的 觀察 |
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金秀子, 趙英珠, 崔純子 |
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梨花女子大學校 醫科大學小兒科學數室 |
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| Abstract |
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Despite better aseptic obstetric technic and advances in antibacterial therapy, neonatal septicemia still plays a important and often unrecognized role in neonatal morbidity and mortality. Even at the present time, however, few data are available on its true incidence because of the relative infrequency with which blood culture of newborn infants arf made. Inadequate prenatal and perinatal cares including home delivery and inproper aseptic obstetric techniqe are the main contributing factors of high morbidity and mortality of the newborn in this country. The present report of 67 cases of septicemia in the newborn seen in the pediatric department of
Ewha University Hospital during a period of three years (Sept. 1964 to Aug. 1967) illustrates the frequency (incidence), clinical manifestation, laboratory findings and etiologic agents (organism). The final diagnosis of septicemia, based on the growth of organism from the blood, however, omphalitis, G-I symptom, fever, abdominal distension and icterus were the most common clinical manifestations suggesting sepsis. (1) The commonest causative organisms found were pathogenic E. coli, Staphylococcus aureus, paracolon bacillus, and pseudomonas aerogenosa. Septicemia was produced by E. coli in 16 patient out of 67 (23,8%), staphylococcus aureus in 12 patients (17.9%), paracolon bacillus in 8 patients, Pseudomonas aerogenosa in 7 patients. (2) Maternal diseases and difficult deliveries were recorded in 20 instances (29.8% of total 67 patients). Of the 20 cases, seven rupture of the mothers had premature of membrane, six had hydramnios, four had toxemia, two had pyelonephritis, and one had placenta previa. (3)Highest seasonal incidence was in summer (June to August), and lowest (least) in winter (December to Feburary). (4)Male were much prominant in sex incidence at the ratio of 2:1. (5)Over 80.0% of the parients developed the symptoms at birth to two weeks. (6)Most common complication or local manifestation of neonatal septicemia were omphalitis and pyoderma, on contrast to other datas (our series) reporting that meningitis is the most common complication in the U.S.A. (7)Stage of disease, types of causative organisms, prematurity and lower body weight, early diagnosis and intensive antibacterial therapy influence prognosis greatly. Among 67 patients with neonatal septicemia, 17 cases (25.4%) were delivered at Ewha Hospital, 30 cases (25.4%) were born at private clinics, and 20 cases were born at home.
(8)Over all average mortality rate of 23.8%, of which premature baby showed higher mortality rate (41.7%) than that of full-term babies (20.0%) due to neonatal septicemia. (9)The duration of illness in fatal cases was, as a rule, short. Over 50.0% of fatal patients died within 48 hours after onset of disease. (10)Therefore, in order to save the life from neonatal septicemia, early diagnosis and prompt intensive therapy are required. Blood culture should always be taken when a new born infant becomes ill and the diagnosis is obscure. |
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