The Changes of Incidence of Nosocomial Sepsis, and Risk Factors in Extremely Low Birth Weight Infants.

Kim,  Bong Lim; Whang,  Jong Hee; Kang,  Chang Kyu; Sim,  Je Won; Kim,  Shung Shin; Chang,  Yun Sil; Park,  Won Soon; Choi,  Eung Sang

Original Article

Journal of the Korean Society of Neonatology 2002;9(1):12-20.
Published online May 1, 2002.

The Changes of Incidence of Nosocomial Sepsis, and Risk Factors in Extremely Low Birth Weight Infants.

Bong Lim Kim, Jong Hee Whang, Chang Kyu Kang, Je Won Sim, Shung Shin Kim, Yun Sil Chang, Won Soon Park, Eung Sang Choi

¹Department of Pediatrics, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea. wspark@smc.samsung.co.kr
²Department of Pediatrics, Collage of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
³Department of Pediatrics, Chung-Ang University College of Medicine, Seoul, Korea.

초극소 저출생 체중아에서 병원감염 패혈증의 발생빈도 및 위험인자들의 시기에 따른 변화

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Abstract

PURPOSE
To know whether the changes in the risk factors of nosocomial sepsis had an impact on the occurrence of nosocomial sepsis (NS) in extremely low birth weight infants (ELBW I).
METHODS
ELBW I who were admitted to the NICU at Samsung Medical Center from October 1994 to December 2000 were devided into three groups according to periods (period I:1994.10-1996.9, period II:1996.10-1998.12, period III:1999.1-2000.12), and charts were reviewed retrospectively for demographic profile, incidence of NS, and changing patterns of risk factors of NS.
RESULTS
Gestational age and birth weight of ELBW I decreased and the incidence of NS increased significantly during third period. However, cumulative incidence of NS corrected by hospital days was not changed irrespective of periods. Among the risk factors of NS in 3rd period, use of antibiotics in the 1st day, postnatal dexamethasone and use and duration of indwelling umbilical catheters decreased significantly and the use of nasal continuous positive airway pressure increased significantly especially, in ELBW I under 800 g of birth weight. In the ELBW I under 800 g of birth weight, cumulative incidence of NS and mortality among the infants who suffered from NS decreased significantly in 3rd period.
CONCLUSION
Efforts to decrease the risk factors of NS can prevent the increase in incidence of NS in ELBW I.

Key Words: Extremely low birth weight infant; Nosocomial sepsis; Risk factors