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Blood Culture Proven Early Onset Sepsis and Late Onset Sepsis in Very-Low-Birth-Weight Infants in Korea

 Soon Min Lee  ;  Meayoung Chang  ;  Ki-Soo Kim 
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.30(suppl 1) : S67-S74, 2015 
Journal Title
Issue Date
Coagulase/metabolism ; Databases, Factual ; Gestational Age ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/isolation & purification ; Humans ; Incidence ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Kaplan-Meier Estimate ; Republic of Korea/epidemiology ; Risk Factors ; Sepsis/epidemiology* ; Sepsis/microbiology ; Sepsis/mortality ; Staphylococcus/enzymology ; Staphylococcus/isolation & purification
Infant ; Korean Neonatal Network ; Risk Factors ; Sepsis ; South Korea ; Very-Low-Birth-Weight
Neonatal sepsis remains one of the most important causes of death and co-morbidity in very-low-birth-weight (VLBW) infants. The aim of this study was to determine the current incidences of early-onset sepsis (EOS) and late-onset sepsis (LOS), the distribution of pathogens, and the impact of infection on co-morbidities in VLBW infants. We analyzed the data including sepsis episode from 2,386 VLBW infants enrolled in Korean Neonatal Network from January 2013 to June 2014. We defined EOS as a positive blood culture occurring between birth and 7 days of life and LOS after 7 days of life. Sepsis was found in 21.1% of VLBW infants. The risk of sepsis was inversely related to birth weight and gestational age. EOS was found in only 3.6% of VLBW infants, however the mortality rate was as high as 34.1%. EOS was associated with the increased odds for bronchopulmonary dysplasia and intraventricular hemorrhage. The vast majority of EOS was caused by Gram-positive organisms, particularly coagulase-negative staphylococci (30.6%). LOS developed in 19.4% of VLBW infants with a 16.1% mortality rate. Pathogens in LOS were dominated by coagulase-negative staphylococci (38.3%). Twenty-five percent and fifty percent of first LOS episode occurred after 12 days and 20 days from birth, respectively. Younger and smaller VLBW infants showed the earlier occurrence day for the 25% of first LOS episode. This study provides a recent nationwide epidemiology of sepsis in VLBW infants in Korea. Based on this study, successful strategies to reduce infections would improve survival and reduce morbidity.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Soon Min(이순민) ORCID logo https://orcid.org/0000-0003-0174-1065
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