All issues > Volume 36(11); 1993

Original Article

J Korean Pediatr Soc. 1993;36(11):1542-1554. Published online November 15, 1993.

Comparison between Preterm and Fullterm infants in Neonatal Sepsis

Sung Hee SH Kim¹, Kum Hee KH Hur¹, Hee Sup HS Kim¹, Myoung Jae MJ Chey¹, Kil Hyoun KH Kim¹, Hak Soo HS Lee¹

¹Department of Pediatrics, Gil General Hospital, Incheon, Korea

Abstract

We retrospectively evaluated datas on 61 cases of neonatal sepsis confirmed by clinical symptoms and blood cultures at the NICU of Gil General Hospital From Mar. 1989, to Reb. 1992. The result obtained were as follows : 1) The mean gestational age was 32.7±2.6 weeks in preterm infants, and 39±1.5weeks on term infants. The mean birth weight was 1,701.4±422.4g in preterm infants, and 3,232.1±581.7g in term infants. 2) There were 61 infants with neonatal sepsis identified among 13,486 live births, resulting in an incidence of 0.45%. The sex ratio of male to female was 1.2 : 1. The incidence was higher in preterm infants(2.21%) than in term infants(0.27%). 3) The most common presenting symptoms of neonatal sepsis were apnea and bradycardia(53.6%) in preterm infants, jaundice(33.3%) in term infants. 4) The concurrent diseases in neonatal sepsis were urinary tract infection(UTI)(25%), pneumonia was the most frequently associated disease in preterm infants, UTI(41.4%) in term infants. 5) Gram positive organisms were isolated in 33 cases(52%), gram negative organisms in 30 cases(48%). The most common ortanism isolated from blood cultures was CONS(28.6%). The more common organisms in preterm infants were CONS(26.7%), Enterococcus(23.3%) and Klebsiella(10%). CONS(30.3%), E. Coli(27.3%) and Staphylococcus aureus(12%) were more frequent in term infants. 6) The significant diagnostic labratory findings for neonatal sepsis were leukopenia(≤5000), I : T≥0.16, thrombocytopenia(≤150,000/㎣), CRP≥1+, 2 or more of abnormal gematologic values were significantly more frequent in preterm infants(p<0.05). 7) The risk factors associated with neonatal sepsis were endotracheal intubation(57%), birth ashyxia (Apgar score≤6 at 5 min.)(39%) and umbilical catheterization(35.7%) in perterm infants, while endotrachial intubation(12.1%) and premature rupture of membrane(≥24hrs)(9.0%) in term infants. 8) Early onset neonatal sepsis(72≤hr of age) was found in 40 cases(65.6%). 9) The overall mortality rate of neonatal sepsis was 26.0%(39.3% in preterm infants, 15.2% in term infants). The mortality rate was significantly high in pseudomonas infection. 10) In low birth weight infants, the susceptibility to neonatal sepsis was greatest in the infants of lowest birth weight(1,00-1,500gm) and the mortality rate was inversely proportional to birth weight. 11) Sensitivity to antibiotics in gram positive organisms were chlorampjenicol(37%), Erythas vancomycin(29%), ampicillin(26%) and cephalothin(26%). It clearly showed that the newer antibiotics such amikacin(85%), gentamicin(65%), tobramycin(58%) and cephalothin(54%).

Keywords :Neonatal sepsis, Preterm infants, Term infants