Trends in epidemiology of neonatal sepsis in a tertiary center in Korea: a 26-year longitudinal analysis, 1980-2005

Abstract

There were many reports of longitudinal changes in the causative organisms of neonatal sepsis in Western countries but few in Asia. We aimed to study longitudinal trends in the epidemiology of neonatal sepsis at Seoul National University Children's Hospital (SNUCH), a tertiary center in Korea, and compared the results to previous studies of Western countries. The medical records of all of the neonates who were hospitalized at SNUCH from 1996 to 2005 with positive blood cultures were reviewed. We also compared the findings to previous 16-yr (1980-1995). One hundred and forty-nine organisms were identified in 147 episodes from 134 infants. In comparison with the previous 16-yr studies, there was a decrease in the number of Escherichia coli infections (16.2% vs 8.7%: odds ratio [OR] 0.495; 95% confidence interval [CI], 0.255-0.962; P = 0.035), but an increase in Staphylococcus aureus (16.6% vs 25.5%: OR 1.720; 95% CI, 1.043-2.839; P = 0.033) and fungal infections (3.3% vs 18.7%: OR 6.740; 95% CI, 2.981-15.239; P < 0.001), predominantly caused by Candida species. In conclusion, the incidence of sepsis caused by E. coli decreases, but S. aureus and fungal sepsis increases significantly. Compared with Western studies, the incidence of sepsis caused by S. aureus and fungus has remarkably increased.

Keywords: Epidemiology; Organism; Sepsis.

Fig. 1

Comparison of the clinical symptoms of neonatal sepsis between early ages (< 32 weeks of PMA) and late ages (≥ 32 weeks of PMA). ^*P < 0.05. PMA, postmenstrual age.

Fig. 2

Comparison of the percentage of the cause of neonatal sepsis; 1980-2005. Data presented as percent (%). CONS, coagulase-negative Staphylococcus; GBS, group-B Streptococcus. ^*P < 0.05 vs Period I+II and Period III; ^†P < 0.05 vs Period I and Period II; ^‡P < 0.05 vs Period I and Period III; ^§P < 0.05 vs Period II and Period III.