Association between neutropenia and death rate of bacterial neonatal sepsis
Abstract
Background Neonatal sepsis remains a crucial problem with highmorbidity and mortality. Not less than four million neonates die
every year, 99% of which occur in developing countries with
infection as the main cause (36%) of death. The prognostic
factors of bacterial neonatal sepsis vary. However the death rate
in neonatal sepsis with neutropenia is suspected to be higher than
that in non-neutropenic condition.
Objectives The purpose of this study was to identify whether
neutropenia would increase the death risk of bacterial neonatal
sepsis.
Methods We conducted a retrospective cohort study. Subjects
were neonates at Instalasi Maternal Perinatal (IMP) of Dr. Sardjito
Hospital in Yogyakarta who met the eligibility criteria. During
the five-year period Qanuary 2002- January 2007), out of 1821
cases of suspected neonatal sepsis, 365 (16.7%) were found to
have bacterial cause in the culture of body's fluid (blood, urine,
and cerebrospinal). Out of these 16.7% patients suffering from
neutropenia, 39.6% patients died, whereas 9.1 o/o patients were
survive [RR 4.72, (95% CI: 2.49 to 8.93), P < 0.01].
Conclusion Neonates suffering bacterial sepsis with neutropenia
had death risk 4.7 times higher than those who did not have
neutropenia.
References
TL, Cunningham MP, Eyal FG, editors. Neonatology. 5rh ed.
Canada: Prentice Hill International; 2005. p. 20-9.
2. IDAI. Standar pelayanan medis kesehatan anak. Sepsis
neonatorum. 1st ed. Jakarta; IDAI 2004. p. 286-90.
3. RSUP Prof. DR. Sardjito. Standar pelayanan medis. Sepsis
neonatorum. Yogyakarta: IDAI 2003. p. 16-23.
4. Bellig LL. Neonatal Sepsis. eMedicine Journal 2002;3,
number 7.
5. LawnJE, CousenS, Zupan]. For the Lancet neonatal survival
steering team. Neonatal survival 1.4 million neonatal deaths:
when? where? why? Lancet 2005;365:891-900.
6. IDAI. UKK Perinatologi. Analisis situasi rumah sakit
rujukan/pendidikan Oi Indonesia Tahun 2003. Jakarta:
IDAI 2005.
7. Cairo MS, Worcester CC, Rucker RW Randomized trial
of granulocyte transfusions versus intravenous immune
globulin therapy for neonatal neutropenia and sepsis. J Pediatr
1992; 120:281-5.
8. Schibler K, Osborne K, Leung L, Le T, Baker S, Thompson
DA. Randomized placebo-controlled trial of granulocyte
colony-stimulating factor administration to newborn infants
with neutropenia and clonical sign of early-onset sepsis.
Pediatrics 1998; 102:6-13.
9. Weber MAR, Candiani CL, Garcia JLA, Castrellon PG,
Arriga FS. Morbidity and mortality from neonatal sepsis
in a tertiary care-level hospital. Salud Publica Mex
2003;45:90-5.
10. Funke Annete, Berner R, Traichel B, Schmeisser 0, Leititis
JU, Neinemeyer CM. Frecuency, natural course, and outcome
of neonatal neutropenia. Pediatrics 1999; 106:45-51.
11. Christensen RD, Rothstein G, Anstall HG, Bybee B.
Granulocyte transfusion in neonates with bacterial infection,
neutropenia, and depletion of mature marrow neutrophyl.
Pediatrics 1982; 70: 1-6.
12. Permono B, Sutaryo, Urgasena lOG, Windiastuti E,
Abdulsalam M. Sel darah putih. In: Hematologi dan onkologi
anak. Jakarta: IDAI; 2005. p. 101.
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Accepted 2016-09-12
Published 2016-09-15