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1세 미만아 패혈증의 임상적 고찰

Clinical Observation on Sepsis in Children under 1 Year of Age

계명의대논문집 1993년 12권 4호 p.500 ~ 509
김명성, 김홍열,
소속 상세정보
김명성 (  ) - 계명대학교
김홍열 (  ) - 계명대학교

Abstract


Since the clinical features of neonatal sepsis were reported by Dunham 1933, there have been reported many studies for sepsis. Because of the variability of the symptoms and signs and rapid disease progression especially in early age group, the
mortality rate of sepsis runs still high.
This study was conducted on 81 cases of sepsis in children under 1 year of age who were admitted at Pediatric department of Dongsan Medical Center of Keimyung University, School of Medicine between Jan. 1989 and Jul. 1992. The diagnosis of sepsis
was
made by clinical symptoms and the positive blood culture.
@ES The results were as follows:
@EN The Male to female ratio was 2.2 : 1 and 72 cases(86.7%) were under the age of 1 month.
The clinical manifestations on admission were fever(65.4%), gastrointestinal symptoms(49.4%), poor feeding(35.8%), grunting(25.9%), lethargy(19.8%), and jaundice(17.3%), in order of frequency.
Leukopenia(WBC count less than 5,000/㎣) was seen in 8 cases(9.9%) and 27 cases(33.3%) showed leukocytosis(WBC count more than 15,000/㎣).
Thrombocytopenia (platelet count less than 150,000/㎣) was found in 12 cases (14.8%).
The associated diseases were pneumonia(22.2%), neonatal hyperbilirubinemia(17.3%), meningitis(8.6%), DIC(8.6%), local abscess(8.6%), in order of frequency.
Of the 81 cases, gram positive organisms were isolated in 56 cases(69.1%) and gram negative organisms in 25 cases(30.9%). The principal organisms were Staphylococcus aureus(25.9%), E. coli(16.1%), Staphyloccus epidermidis(13.6%), group B
hemolytic
streptococcus(11.1%), enterococcus(8.6%), and enterobacter(8.6%).
Gram positive organisms were sensitive to cephalothin(96.3%), clindamycin(79.5%), and erythromycin(76.0%) and resist to ampicillin. Gram negative organisms were sensitive to amikacin(89.3%) and showed moderate sensitivity to gentamycin(53.6%).
Staphylococcus aureus showed sensitivity to chloramphenicol(100%), clindamycin(90%) and erythromycin(70%) and Staphylococcus epidermidis was sensitive to cephalotin(90%) and amikacin(90%). Cephalothin and erythromycin showed 100% sensitivity to
group B
streptococcus, and E. coli were sensitive to amikacin(93%).
The mortality rate was 28.3%.

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