Journal of the Korean Pediatric Society 1975;18(8):567-576.
Published online August 31, 1975.
Clinical Observation in 157 Cases with Neonatal Septicemia
Whan Kok Yong, Dong Gi Shin, Chui Kyu Kim, Soon Ja Kwon
Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
신생아 패혈증에 관한 임상적 고찰
용환극, 신동기, 김철규, 권순자
이화여자대학교 의과대학 소아과학교실
Abstract
An analysis presented of 157 cases of neonatal septicemia in Korean infants under 1 month of age, treated at the pediatric ward and the isolation room of the nursery, Ewha Womans University Hospital from Jan. 1, 1968 to Aug. 31, 1974. The followings were noted. 1)Yearly distribution was revealed as the highest in 1971(23. 6%) and 26 cases(16. 6%) in 1972, 3 cases(l. 9%) in 1973. The number of patients was gradually declined since 1973. 2)The male was 98 cases(62.4%) and the female, 59 cases(37.6%) The male to female ratio was 1.5 : 1. 3) Seasonal distribution was revealed as the highest in summer and autumn as 46 cases (29.9%), respectively. And it was the lowest in winter(19.1%), 4)According to the distribution of age, there was the lowest incidence under the 24 hours of age since after birth as 11 cases(7%). It accounted to 80.9% of all the septicemic infants from 1 day to 14 days of age. 5)According to the distribution of body weight, the lowest incidence under the 2kg of body weight(6. 0%) and the highest in 3.1~4. 0kg (30. 5%). There are relatively higher incidence in high birth weight (over than 4. 0kg) as 29 cases(18. 4%) than that of lower birth weight. 6) Maternal disease were recorded in 38 cases of total 157 cases. Of the 38 cases, 22 cases (25.9%) had premature rupture of membrane, 15 cases (39.4%) had toxemia, 1 case (2.7%) had placenta previa. 7)The underlying diseases of neonatal septicemia were omphalitis (28.7%), pneumonia (24.8%), hyperbilirubinemia(22%) in order of frequency. 8)Clinical data that support a diagnosis of neonatal septicemia included as following results in its frequency. In clinical history, 22% had prematurity, 14.1% had premature rupture of membrane, 6.4% had congenital heart diseases. In the manifestations of central nerve system, there were irritability (14.1%), convulsion(10.8%), apnea(7.6%) in orders. In those of respiratory system, there were dyspnea (17. 9%), tachypnea (14.7%), cyanosis (14.1%), Vomiting (14.7%), diarrhea(14.1%), hepatomegaly(6.3%) were involved in those of digestive system. In hematologic manifestations, there were jaundice(30. 6%) and splenomegaly(7. 6%) in orders of frequency. In general, the commonest manifestation of neonatal septicemia was fever(39,4%). 9) The normal values of the red cell count over than 4million per cubic millimeter had 1.5% of all the septicemic infants. The range of hemoglobin from 12.1 gm % to 16. 9 gm% had 39.1%. The severe degree of anemia below than that of 12gm% showed 23.9%. The white blood cell count had a wide range of normal values in the newborn period. Leukopenia (<5000 white blood cells per cubic millimeter) includedi in 3. 9% and leukocytosis(>25000 white blood cells per cubic millimeter) in 9.1% of all the cases of neonatal septicemia. 10) The commonest organism on the examination of blood culture showed Staphylococcus aureus(21.5%). No organism grew on blood culture as 73.2% of all the cases. 11)In yearly mortality rate, there was the highest in 1968(26.1%'). The mortality rate of neonatal septicemia was gradually decreased since after 1971. 12) There was special relation between the places of delivery and mortality rate. The mortality rate was higher(38.7%) in cases with home delivery than those with hospital delivery (4.6%). 13)The mortality rate was also higher(26.5%) in the cases of lower birth weight less than 2.5kg of body weight than the caws over than 2.5 kg of body weight(12.2%). 14) The average mortality rate was 15.2%. In the relationship between the birth weight and the mortality rate, lower birth weightfless than 2.5kg) showed higher mortality rate(26.5 %) than that of birth weight over than 2.5kg(12.2%).




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