Predictive Factors Of Prognosis In Neonatal Early-onset Sepsis

Objective:To explore the predictive factors of neonatal early-onset sepsis(EOS).Methods:The clinical data of 371 cases of EOS admitted to our hospital from Jan.2018 to Jan.2019 were collected and were divided into the good prognosis group(264 cases)and the poor prognosis group(107cases).The perinatal conditions,clinical manifestations,laboratory parameters,complications,and treatment were compared and analyzed.Logistic regression was used to analyze the risk factors for poor prognosis of EOS.Results:(1)In the total 371 EOS patients,324(87.3%)patients survived while 47(12.7%)patients died,264(71.2%)were discharged completely,and 60(16.1%)had sequelae.The sequelae included 27 cases(45.0%)with bronchopulmonary dysplasia,16 cases(26.6%)with intestinal perforation,and 20 cases(33.3%)with adverse outcomes for Glasgow Outcome Scale(GOS).Among them,2 cases of BPD combined with intestinal perforation and 1 case of BPD combined with GOS adverse outcome.(2)Among 371 children with EOS,22 cases(5.9%)were positive for blood culture.14(63.6%)were Gram-positive bacteria,7(31.8%)were Gram-negative bacteria,and 1(4.5%)was fungus.The pathogenic bacteria of EOS are mainly coagulase-negative Staphylococcus cons(CONS)(54.5%)and Escherichia coli(22.7%).(3)The result of univariate analysis shows that premature birth,low birth weight,very low birth weight(VBLW),twins,poor response,poor breathing,abdominal distension,convulsions,WBC>25×10~9/L,WBC<5×10~9/L,platelets<100×10~9/L,anemia,coagulopathy,renal dysfunction,Liver damage,hypoproteinemia,hypoglycemia,pathologic jaundice,neonatal respiratory distress syndrome(NRDS),pulmonary hemorrhage,necrotizing enterocolitis(NEC),intraventricular hemorrhage,purulent meningitis,brain injury,pulmonary hypertension,shock,mechanical ventilation and use of vasoactive drugs are related to poor prognosis in EOS.(4)Multiple logistic regression analysis shows that risk factors for EOS included the following:VLBW,NEC,brain injury,shock,mechanical ventilation,hepatic damage.Conclusion:VLBW,NEC,brain injury,shock,mechanical ventilation,hepatic damage predict a poor prognosis of EOS.According to these factors,effective treatment should be taken to reduce the sequelae rate of EOS.