All issues > Volume 47(10); 2004

Original Article

Korean J Pediatr. 2004;47(10):1058-1064. Published online October 15, 2004.

A Clinical Study of Sepsis with Thrombocytopenia in Premature Infants

Jae Hoon JH Sim¹, So Ick SI Jang¹, Yun Jung YJ Sim¹, Do Jun DJ Cho¹, Dug Ha DH Kim¹, Ki Sik KS Min¹, Ki Yang KY Yoo¹

¹Department of Pediatrics, College of Medicine, Hallym University, Chunchon, Korea

Correspondence Dug Ha DH Kim ,Email: dougkim@hallym.or.kr

Abstract

Purpose
: This study was performed to characterize sepsis with thrombocytopenia in premature infants to determine if thrombocytopenia is a prognostic factor in sepsis in premature infants.
Methods
: We retrospectively analyzed the medical records of sepsis in premature infants admitted to the neonatal intensive care unit(N=41) at the Hallym University Sacred Heart Hospital from January 1999 to December 2002. The incidence, risk factors, symptoms, hematologic and bacteriologic findings were analyzed during episodes of sepsis.
Results
: Of the 41 cases, 29(72%) were associated with thrombocytopenia. The ratio of male to female was 1.2 : 1. The vast majority(98%) were late-onset sepsis. The risk factors of the thrombocytopenic group were low birth weight and low gestational age. Major symptoms were poor activity (72%), apnea/tachypnea(52%), but were not significantly different between two groups. In the thrombocytopenic group(N=29), low total WBC count and high CRP level were discovered(P=0.03, P<0.01). The mean platelet count was 70.17(?03/mm3) at diagnosis of sepsis, and a mean platelet nadir was 43.10(?03/mm3). The severe thrombocytopenia(below 50?03/mm3) in the thrombocytopenic group was discovered in 69% and the duration of thrombocytopenia was about eight days. The majority of pathogens were gram-negative bacteria and candida. The thrombocytopenic group showed a prolonged length of stay and a high mortality rate. According to comparisons between the survived and expired groups, low birth weight, low gestational age, neutropenia and thrombocytopenia were significantly correlated with mortality(P<0.05).
Conclusion
: The sepsis with thrombocytopenia in premature infants showed late-onset sepsis and high morbidity and mortality, although differences were not significant statistically. Especially, low birth weight and low gestational aged infants should be cautiously treated and monitored.

Keywords :Premature infant, Sepsis, Thrombocytopenia