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Korean J Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2018.06807    [Accepted]
Published online September 27, 2018.
Clinical features and prognostic factors of early-onset sepsis : a 7.5-year experience in one neonatal intensive care unit
Se Jin Kim, Ga Eun Kim, Jae Hyun Park, Sang Lak Lee, Chun Soo Kim 
Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
Correspondence:  Chun Soo Kim, Tel: +82-53-250-7526 , Fax: +82-53- 250-7783, 
Email: cskim@dsmc.or.kr
Received: 26 July 2018   • Revised: 17 September 2018   • Accepted: 27 September 2018
Abstract
Purpose
This study was undertaken to investigate the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients.
Methods
A retrospective analysis of the medical records was conducted in a NICU of a university hospital over a 7.5-year period (Jan 2010-Jun 2017).
Results
During the study period, there were 45 (1.2%) episodes of EOS in 3,862 infants. The most common pathogen responsible for EOS was Streptococcus group B (GBS) in 10 cases (22.2%), followed by E. coli in 9 cases (20%). The frequency of Gram-positive sepsis was higher in term than in preterm infants, while the rate of Gram-negative infection was higher in preterm than in term infants (P<0.05). The overall mortality was 37.8% (17 of 45), and 47% of deaths occurred within the first 3 days of infection. There was a significant difference in terms of gestational age (26.8 weeks vs. 35.1 weeks) and birth weight (957 g vs. 2,520 g) between the death and survival groups. In a comparison after adjusting for the difference in gestational age and birth weight between the two groups, Gram-negative pathogens (OR: 42, 95% CI: 1.4~1281.8) and some clinical findings, such as neutropenia (OR: 46, 95% CI: 1.3~1628.7) and decreased activity (OR: 34, 95% CI: 1.8~633.4), were associated with fatality.
Conclusion
The common pathogens responsible for EOS in NICU patients are GBS and E. coli. Infection caused by Gram-negative bacteria, decreased activity in the early phase of infection, and neutropenia were associated with poor outcomes.
Key Words: Early-onset sepsis, Clinical features, Prognosis, Neonatal intensive care unit


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