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KMID : 0367420040470101058
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Journal of Korean Pediatric Society
2004 Volume.47 No. 10 p.1058 ~ p.1064
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A Clinical Study of Sepsis with Thrombocytopenia in Premature Infants.
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Sim Jae-Hoon
Jang So-Ick
Shim Eun-Jung
Cho Do-Jun
Kim Dug-Ha
Min Ki-Sik
Yoo Ki-Yang
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Abstract
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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(×103/mm3) at diagnosis of sepsis, and a mean platelet nadir was 43.10(×103/mm3). The severe thrombocytopenia(below 50×103/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. (Korean J Pediatr 2004;47:1058-1064)
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KEYWORD
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Premature infant, Sepsis, Thrombocytopenia
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