혈액 배양 균 양성 신생아 패혈증의 임상적 고찰

• Published in: Kosin Medical Journal (Online) pp. 119 - 125
• Main Authors: 이정현, 여순, 박재선
• Format: Journal Article
• Language: Korean
• Published: 고신대학교 의과대학 학술지 01.08.2006
• Subjects: 의학일반
• ISSN: 2005-9531; 2586-7024

Background : Septicemia is one of major causes of mortality and mobidity in neonatal period and early diagnosis and appropriate treatment of neonatal septicemia are difficult due to its vagueness of symptom and rapid progression. Early empirical use of antibiotics in neonates with septicemia is very important, as delaying or inappropriate use of antibiotics could have a fatal outcome. Methods : Five hundred and fifty nine neonates admitted to NICU of Kosin University Hospital for the period of 3 years from January of 2000 to December of 2002 were reviewed retrospectively. The 42 cases of blood culture positive neonatal septicemia were evaluated in terms of frequency, clinical manifestations, underlying conditions, etiologic organisms, results of antibiotics sensitivity test and mortality rates. Results : The frequency of blood culture positive neonatal septicemia was 7.5% (42 in 559 live birth). The frequency of bacterial septicemia is 1.2 times higher in males than in female. Septicemia was more prevalent in preterm infants than in full term infants. Maternal bleeding was the most frequent perinatal complication. Clinical manifestations observed in neonatal septicemia were abdominal distention, body temperature instability, respiratory symptom, jaundice, poor feeding, lethargy, skin lesion and convulsion in order of decreasing frequency. Underlying conditions associated with neonatal septicemia were respiratory distress syndrome and congenital heart disease which were the two most common, and followed by urinary tract infection, intraventricular hemorrhage and pneumothorax in order of frequency. Of the 43 strains of bacteria cultured, coagulase-negative staphylococcus was the most common pathogen. Rates of sensitivity to vancomycin and ciprofloxacin in gram positive organisms were 100% and 85.3%, respectively. Gram negative organisms showed 100% in sensitivity to ciprofloxacin, trimethoprim/sulfamethoxazole and imipenem-cilasatin. Ampicillin, cephalothi, and gentamycin showed low rates in antibiotic sensitivity test. Conclusion : Conventional antibiotics such as ampicillin, cephalothin or gentamycin do not seem to be appropriate for empirical therapy for suspected neonatal septicemia while vancomycin with impenem or amikacin would cover most of the organisms. KCI Citation Count: 0