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KMID : 0378019890320110036
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New Medical Journal
1989 Volume.32 No. 11 p.36 ~ p.42
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Clinical Observation in 42 Cases with Neonatal Sepsis
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Abstract
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Bacterial sepsis continues to cause important mortality and morbidity in the neonate. The case fatality rates vary from 20% to 50% according to reporters, depending on risk ´actors such as gestational age, age at time of onset and the causative bacteria. But because .f the ascertainty of early symptoms and it´s rapid progression to septic shock and DIC, neonatal sepsis is still large and important portion of neonatal death. We reviewed 42 cases of n- .natal sepsis confirmed by blood culture studies and clinical symptoms for 6 years between Jan. 1983 and Dec. 1988 at Korea University Hospital.
The results obtained were as follows
1) The sex ratio of patients was 1.8:1 with 27(67.2%) males and 15(32.8%) female..
2) There was frequent association of perinatal complications including difficult abor in
14.3%, premature rupture of membrane over 24 hour in 9.5%, meconium staining in
9.5%.
3) Clinical symptoms at the time of admission consisted of jaundice in 47.6%, f; ;.G´ g difficulty in 30.9%, temperature unstability in 28.6% irritability in 14.3%, dyspnea in 14.3%, and lethargy in 11.9%.
4) Among the associated diseases, the hyperbilirubinemia was seen in 47.6%, urinar tract infection in 33.3%, localized abscess in 9.5%, bacterial meningitis in 9.5% and omphalitis in 4.8%.
5) Leukocytosis with WBC count above 25,000 / mm3 was seen in 9.5% of ca -. and leukopenia less than 5,000 / mm3 was seen in 11.9% of cases. Thrombocytopeni. with platelet count of less than 150,000 / mm3 was found in 29.2% of cases.
6) Of the 42 cases of neonatal sepsis, the following causative organisms were iso ated ; Gram positive organisms were isolated in 28 cases(66.7%), and gram negative organisms in 16 cases(38.9%). Among the gram positive organisms, the Staphylococcus epide midis was isolated in 14 cases(33.3%), Staphylococcus aureus in 8 cases(19.0%) and Streptococcus in 5 cases(11.9% ). Among the gram negative organisms, E.coli was isolated in 6 cases(14.3% ), Pseudomonas in 3 cases (7.1% ), Klebsiella in 2 case (4.8%) and Serra tia in 2 cases(4.8%).
7) The case fatality rate was 14.3% and the mortality was higher in early onset type than in late onset type.
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KEYWORD
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