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Clinical Observation of Neonatal Sepsis

Journal of the Korean Pediatric Society 1993;36(5):671-679.
Published online May 15, 1993.
Clinical Observation of Neonatal Sepsis
Jin A Son, Soon Wha Kim, Don Hee Ahn, Keun Chan Sohn
Department of Pediatrics, National Medical Center, Seoul, Korea
신생아 패혈증의 임상적 관찰
손진아, 김순화, 안돈희, 손근찬
국립의료원 소아과
Abstract
Ninety two cases of culture proved neonatal sepsis who had been admitted to pediatric department, National medical Center, during 7 years from Jan, 1984 to Dec, 1990 were reviewed clinically and the following results were obtained. 1) The frepuency of neonatal sepsis was 3.1% and male to female sex ratio was 1.9:1, Sepsis was more prevalent in prenature infants (9.9%) than in full term infans (1.9%). 2) The seasonal incidence was more prevalent in summer (32.6%). 3) The weight distribution showed 50 cases with the weight less than 2500 gram and 42 cases more than 2500 gram. 4) In 76 cases the onset was before 7 days old and in 16 cases were developed after 7 days old. 5) The major associated perinatal conditions in neonatal sepsis were institutional baby (23.9%), premature rupture of membranes (11.9%) and placenta previa (4.3%) in the order of frequency. The clinical manifestations on admission were jaundice (50.0%), poor activity (46.7%), respiratory difficulty (35.9%), poor feeding (22.8%), cyanosis (22.7%), gastrointestional symptoms (21.5%), fever (15.2%) and convulsion (13.0%) in the order of frequency. 6) The associated diseases were urinary trct infection (31.5%), hyaline membrane disease (19.6%), congenital disorder (18.5%), pneumonia (15.2%), anemia (13.0%), meningitis (9.8%), omphalitis (7.6%), DIC (6.5%), necrotizing enterocolitis (5.4%) and intracranial hemorrhage (5.4%) in the order of frequency. 7) Causative organisms were gram positive organisms in 27 cases (25.7%) and gram negative organisms in 79 cases (74.3%). The main organisms were Serratia marcescens (18.5%), Enterobacter spp (17.4%), Klebsiclla pneumoniae (12.0%), Staphylococcus aureus (10.9%), Acinetobactor clacoaceticus (8.7%), Coagulase (-) staphylococcus (8.7%), E, coli (8.7%), Enterococcus (6.5%), Group B β-hemolytic streptococcus (5.4%) and Pseudomonas (5.4%) in the order of frequency. The sensitivity to antibiotics were. Senatia marcescens; 70.6% sensitive to Amikacin 58.9% sensitive to Cefotaxime Enterobacter spp : 87.5% sensitive to Amikacin 68.6% sensive to Cefotaxime Klebsiella pneumoniae : 100% sensitive to Amikacin 91.0% sensitive to Cefotaxime Staphylococcus aureus : 100% sensitive to Cefazolin 90.0% sensitive to Cefotaxime Acinetobacter calcoaceticus : 88.9% sensitive to Amikacin Coagulases (-) Staphylococcus : 100% sensitive to Amikacin 87.5% sensitive to Cefotaxime E.coli : 100% sensitive to Amikacin, Cefotaxime Enterococcus : 50% sensitive to Gentamicin, Ampicillin, Amikacin Group Bβ- hemolytie Streptococcus : 100% sensitive to Ampicillin, Penicillin Pseudomonas : 100% sensitive to Amikacin, Gentamicin, Tobarmycin 8) Mortality cases were 32 cases (34.8%).
Key Words: Neonate, Sepsis


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