Changing trend of neonatal infection: Experience at a newly established regional medical center in Korea

Abstract

Background:The purpose of the present paper was to study the natural history of neonatal sepsis in a newly established neonatal intensive care center that started in 1988 at Gyeongsang National University Hospital 9 (GNUH) in Chinju city, Korea. Methods:Neonates admitted to GNUH neonatal intensive care unit (NICU) between January 1988 and December 1997 were included. All organisms detected on blood and cerebrospinal fluid cultures were recorded. Neonatal sepsis was defined as 'clinical signs suggestive of sepsis with a positive blood and/or cerebrospinal fluid culture during the neonatal period'. Temporal trends and the distribution of pathogens in identified septic patients during the aforementioned period were studied descriptively. Results:Between January 1988 and 31 December 1997, 3327 neonates were admitted to the center. A total of 6.7% of neonates (224/3327) had at least one positive blood culture. The vast majority (62%) of septic cases were caused by Gram-positive organisms. Coagulase-negative staphylococci (CONS) were the most common pathogens (24% of all infections, 38% of Gram-positive infections). The pathogen associated with the highest mortality was Klebsiella pneumoniae (25%, 10/39). Sepsis as a result of Gram-negative pathogens (especially K. pneumoniae) were involved in outbreaks that occurred for a few years during the study interval. Conclusions: The major outcome of this review was the emergence of CONS in the NICU during a relatively short period of time (10 years) as a common neonatal pathogen. This observation is similar to the experience of other centers over the last two decades.