Risk Factors for Neonatal Sepsis in Premature Infants Admitted to Neonatal Intensive Care Unit

ABSTRACT

PURPOSE: The purpose of this study is to find out the risk factors of sepsis except the prematurity itself. METHODS: Seventy-seven premature infants less than 37 weeks of gestation, who were admitted to the neonatal intensive care unit of Hanyang University Kuri Hospital between July 1995 and December 1996, were enrolled in this study. All 77 premature infants, 14 patients proven to have sepsis by blood culture. They were matched with 24 controls by gestational age and date of birth. The risk factors for neonatal sepsis between the groups were compared. RESULTS: Fourteen of 77 subjects(18.2%) had culture-proven sepsis. Among them, all but one, who had confirmed sepsis on the first day of life, were late-onset >72 hours of age(16+/-6 days of life). Gestational age and birth weight of sepsis group(mean+/-SD) were similar to those of controls 31.6+/-3.6 week vs 31.5+/-3.3 weeks; 1673+/-832g vs 1651+/-513g, and survival rate was also similar between the two groups(n=ll, 79% for sepsis group vs n=20, 77% for the control). In the analyses of risk factors of sepsis only parenteral nutrition and duration of parenteral nutrition were significantly more frequent and longer in the sepsis group compared to the control(n=8, 73% vs n=6, 30%, P=0.022; 20+/-15 days vs 7+/-4 days, P=0.0364). CONCLUSION: Incidence of neonatal sepsis in premature infants <37 weeks of gestaton admitted to neonatal intensive care unit was 18.2%. Ninty-three pevcent of the infants was late-onset sepsis. Sepsis group had more frequent use and longer duration of parenteral nutrition. In order to reduce neonatal sepsis in premature infants, use and duration of paventeral nutrition should be restricted.