Risk Factors And Laboratory Indicators Of Neonatal Early-onset Sepsis

Objective:To investigate the risk factors and laboratory indicators of early diagnosis of early-onset neonatal sepsis.Methods:A total of 100 children with early-onset neonatal sepsis admitted to the Pediatric neonatal Ward of the Third Hospital of Shanxi Medical University between January 2017and January 2021 were selected as the infection group(including diagnosis of sepsis in children with 24 cases,clinical diagnosis of sepsis in children with 76 cases),and according to the proportion of 1:1 randomly over the same period during the hospital treated 100 cases of sepsis were as control group,The clinical data of the children and their mothers were retrospectively analyzed.χ~2 test and binary Logistic regression analysis were used to analyze the risk factors of early-onset neonatal sepsis.Laboratory indicators(blood culture,white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT)and platelet count(PLT)within 72 hours after birth were collected,and receiver operating characteristic curve(ROC)was drawn using blood culture results as the gold standard.According to the area under curve(AUC)analysis of valuable indicators for early-onset neonatal sepsis,the sensitivity and specificity were judged.Results:1.100 children with early-onset septicemia(confirmed+clinically diagnosed),among which 24 were positive in blood culture,including 14 gram-positive bacteria(58.33%)and10 gram-negative bacteria(41.67%).The top three pathogens in the number of strains were Staphylococcus aureus(6 cases),Escherichia coli(5 cases)and Streptococcus agalactiae(4cases)respectively.2.In the clinical data of the two groups,five indicators of maternal related factors in the univariate analysis of early-onset neonatal sepsis were statistically significant(P<0.05),including premature rupture of membranes,fecal staining of amniotic fluid,prenatal fever,preeclampsia and gestational diabetes.There were 6 neonatal related factors with statistical significance(P<0.05),including premature birth,fever,intrauterine distress,asphyxia,rescue history and oxygen intake.3.Binary Logistic regression analysis showed premature rupture of membranes(OR=3.992,95%CI:1.552-10.049),prenatal fever(OR=2.568,95%CI:1.865-16.765),preeclampsia(OR=1.436,95%CI:1.162-3.126),fever(OR=8.580,95%CI:4.623-15.403)and preterm birth(OR=3.235,95%CI:1.453-6.237)were independent risk factors for early-onset neonatal sepsis(ALL P<0.05).4.Comparison of laboratory indicators between the infection group and the control group:WBC abnormality,PLT,PCT and CRP were significantly different between the infection group and the control group(P<0.05);The area under ROC curve of single laboratory index(WBC,PLT,CRP and PCT)was 0.405,0.412,0.588 and 0.607,respectively.The area under ROC curve of combined laboratory index(CRP+PCT)was 0.704,and its sensitivity and specificity were 0.682 and 0.738,respectively.Obviously higher than each single index.Conclusion:Early identification of risk factors for early-onset neonatal sepsis,combined application of CRP and PCT non-specific indicators can provide clinical reference for early diagnosis of early-onset neonatal sepsis.