Clinical study on 127 cases with suspected early-onset sepsis

doi:10.3877/cma.j.issn.1674-1358.2018.03.014

Abstract

Abstract:

Objective

To investigate the diagnostic value of related nonspecific indexes in the laboratory factors for neonatal infectious diseases.

Methods

From July 2016 to July 2017, a total of 127 cases with infectious diseases in NICU of Chengde Central Hospital were selected as infection group, while 103 cases of non-infection newborns (0-3 day) were taken as the control group. Perinatal factors, laboratory indicators and other clinical factors were compared between the two groups.

Results

Compared with the control group, initial symptoms such as feeding difficulties (15.7%), breathing difficulties (30.7%), groans (31.5%), yellow skin stains (18.1%) and suffocation (5%) were significantly different in the infection group (χ² = 4.136, 24.574, 33.282, 38.039; all P < 0.001). There were significant differences of perinatal factors between the two groups of newborns with a history of infection in the late stages of pregnancy and premature rupture of the fetal membrane > 18 h (χ² = 10.536, 10.717; both P = 0.001). The results of laboratory indicators showed that the C-reactive protein (CRP), count of white blood cell (WBC) and percentage of neutrophils between newborns in the two groups were all significantly different (t = 2.740, P = 0.008; t = 6.378, P < 0.001; t = 4.860, P < 0.001). The ROC curve analysis of infection group showed that the best cut-off points for CRP, count of WBC and neutrophils were 8.0 mg/dl, 12.65 × 10⁹/L and 63.15%, respectively; the sensitivity were 24.3%, 62.2% and 68.9%, respectively; the specificity were 99.0%, 81.2% and 84.4%, respectively; and the area under the curve (AUC) were 0.544, 0.707 and 0.769, respectively. The combined sensitivity of CRP, count of WBC and neutrophils was 83.8%, the specificity was 75.0%, and the AUC was 0.860, which was significantly higher than the individual index.

Conclusions

The incidence of neonatal infectious diseases is closely related to many perinatal factors, and mainly showed the clinical manifestations of respiratory symptoms. The combined diagnosis of leukocyte count and neutrophil percentage could improve the diagnostic value. The combination of perinatal factors, clinical manifestations and laboratory indexes are beneficial to the early identification of neonatal infectious diseases.

Key words: Newborn, Infective, C- reactive protein, Leukocyte, Neutrophil, Diagnosis

Mengmeng Bai, Lin Meng, Wen Li, Yujie Cui, Dongmei Zhang, Yanfeng Sang, Yongmei Liu, Jing Tang. Clinical study on 127 cases with suspected early-onset sepsis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(03): 272-277.

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References 26

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组别	例数	男[例（%）]	剖宫产[例（%）]	胎龄（ ± s，周）	日龄（ ± s，d）	出生体重（ ± s，kg）
感染组	127	77（71.5）	70（66.3）	37.22 ± 3.18	1.23 ± 1.23	3.02 ± 0.86
对照组	103	53（58.5）	50（53.7）	37.84 ± 2.16	1.47 ± 1.31	3.09 ± 0.66
统计量		χ² = 2.153	χ² = 0.985	t =－1.751	t =－1.421	t =－0.673
P值		0.142	0.321	0.081	0.159	0.502

组别	例数	男[例（%）]	剖宫产[例（%）]	胎龄（ ± s，周）	日龄（ ± s，d）	出生体重（ ± s，kg）
感染组	127	77（71.5）	70（66.3）	37.22 ± 3.18	1.23 ± 1.23	3.02 ± 0.86
对照组	103	53（58.5）	50（53.7）	37.84 ± 2.16	1.47 ± 1.31	3.09 ± 0.66
统计量		χ² = 2.153	χ² = 0.985	t =－1.751	t =－1.421	t =－0.673
P值		0.142	0.321	0.081	0.159	0.502

组别	例数	窒息	喂养困难	呼吸困难	呻吟	皮肤黄染	低血糖	体温异常	抽搐	呕吐腹胀
感染组	127	7（3.9）	20（12.1）	39（24.3）	40（23.2）	23（45.3）	5（5.5）	2（1.1）	3（1.7）	3（1.7）
对照组	103	0（3.1）	2（9.9）	5（19.7）	2（18.8）	59（36.7）	5（4.5）	0（0.9）	0（1.3）	0（1.3）
χ²值		4.136	12.532	24.574	33.282	38.039	0.000	—	0.972	0.972
P值		0.042	< 0.001	< 0.001	< 0.001	< 0.001	0.989	0.503	0.116	0.324

组别	例数	窒息	喂养困难	呼吸困难	呻吟	皮肤黄染	低血糖	体温异常	抽搐	呕吐腹胀
感染组	127	7（3.9）	20（12.1）	39（24.3）	40（23.2）	23（45.3）	5（5.5）	2（1.1）	3（1.7）	3（1.7）
对照组	103	0（3.1）	2（9.9）	5（19.7）	2（18.8）	59（36.7）	5（4.5）	0（0.9）	0（1.3）	0（1.3）
χ²值		4.136	12.532	24.574	33.282	38.039	0.000	—	0.972	0.972
P值		0.042	< 0.001	< 0.001	< 0.001	< 0.001	0.989	0.503	0.116	0.324

组别	例数	孕晚期感染	羊水早破≥ 18 h	羊水粪染	胎心减慢
感染组	127	20（11.6）	19（11.0）	12（12.7）	11（11.0）
对照组	103	3（10.3）	2（9.0）	7（8.5）	9（9.0）
χ²值		10.536	10.717	0.528	0.000
P值		0.001	0.001	0.476	0.984

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