All issues > Volume 45(1); 2002

Original Article

J Korean Pediatr Soc. 2002;45(1):55-63. Published online January 15, 2002.

A Nationwide Survey on the Causative Organisms of Neonatal Sepsis in Korea

Kyung Ah KA Kim¹, Son Moon SM Shin², Jung Hwan JH Choi³

¹Departments of Pediatrics, Collage of M edicine, Ulsan University, Ulsan, Korea
²Departments of Pediatrics, Collage of M edicine, Sungkyunkwan University School of Medicine, Seoul, Korea
³Departments of Pediatrics, Collage of Medicine, Seoul National University, Seoul, Korea

Correspondence Son Moon SM Shin ,Email: smshin@smc.or.kr

Abstract

Purpose
: A nationwide survey was conducted to investigate the most common causative organisms in neonatal sepsis in Korea.
Methods
: By reviewing medical records of newborn infants who were confirmed as neonatal sepsis by isolating organisms from blood culture during a one year study period from January to December in 1997, data for causative organisms, risk factors, accompanying focal infections and combinations of antibiotics were collected.
Results
: 112,351 neonates were born at 55 hospitals in 1997 and 30,767 neonates were admitted to the neonatal units. During this period, 1,175 episodes of neonatal sepsis were recorded in 1,116 neonates. The male to female ratio was 1.17 : 1. 424 cases(36%) were born prematurely. The main pathogens of early-onset sepsis were coagulase negative Staphylococcus(CONS, 19.3%), S. aureus (16.1%), S. epidermidis(16.1%) and Gram negative bacilli(19.2%) including Pseudomonas(5.9%), Klebsiella(3.9%), E. coli (3.9%), Enterobacter spp(3.5%), Acinetobacter(2.0%). Only six cases of group B beta-hemolytic Streptococcus were isolated. Common obstetric factors were premature rupture of membranes(17.3%), maternal leukocytosis(14.6%), fetal tachycardia(10.2%), chorioamnionitis( 3.1%) and maternal fever(3.1%). The main pathogens of late-onset sepsis were S. aureus (20.3%), S. epidermidis(18.9%) and CONS(13.7%). Frequent focal infections accompanying sepsis were arthritis(12.8%), meningitis(7.0%), pneumonia(5.4%) and urinary tract infection(3.1%). The most common combination of antibiotics used in early and late neonatal sepsis was ampicillin and gentamicin. When a nosocomial infection was suspected, a combination of vancomycin and cefotaxime was used most frequently.
Conclusion
: S. aureus and S. epidermidis were the most common pathogens in the neonatal sepsis.

Keywords :Neonatal sepsis, Causative organism, Obstetric factor, Antibiotics