| A Clinical Study of Sepsis with Thrombocytopenia in Premature Infants |
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Jae Hoon Sim, So Ick Jang, Yun Jung Sim, Do Jun Cho, Dug Ha Kim, Ki Sik Min, Ki Yang Yoo |
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Department of Pediatrics, College of Medicine, Hallym University, Chunchon, Korea |
| 혈소판 감소증을 동반한 미숙아 패혈증의 임상 양상 |
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심재훈, 장소익, 심은정, 조도준, 김덕하, 민기식, 유기양 |
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한림대학교 의과대학 소아과학교실 |
Correspondence:
Dug Ha Kim, Email: dougkim@hallym.or.kr
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| Abstract |
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(?03/mm3) at diagnosis of sepsis, and a mean platelet nadir was 43.10(?03/mm3). The severe thrombocytopenia(below 50?03/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. |
| Key Words:
Premature infant, Sepsis, Thrombocytopenia |
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