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KMID : 0438520090160020163
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Journal of the Korean Society of Neonatology
2009 Volume.16 No. 2 p.163 ~ p.171
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Pathogens and Prognotic Factors for Early Onset Sepsis in Very Low Birth Weight Infants.
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Kim Yi-Sun
Koo Soo-Hyun
Park Won-Soon
Kim Jin-Kyu
Yoo Hye-Soo
Lee Kyung-Hoon
Kim Myo-Jing
Jeon Ga-Won
Park Soo-Kyoung
Jeong Yoo-Jin
Choi Seo-Heui
Seo Hyun-Joo
Chang Yun-Sil
Ahn So-Yoon
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Abstract
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Purpose: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants.
Methods: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated.
Results: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants.
Conclusion: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.
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KEYWORD
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Very low birth weight infants, Early onset sepsis
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