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[Five year experience with neonatal sepsis in a pediatric center].

OBJECTIVE
To describe the etiologic agents, clinical findings and hematologic changes associated to sepsis in patients admitted to the Neonatal Intensive Care Unit at the Hospital Infantil de México Federico Gómez and to determine the frequency of normal CBC (Complete Blood Cell Count) at diagnosis of sepsis.


METHODS
A chart review of septic patients hospitalized from January 1992 to December 1996 was done.


RESULTS
103 septic patients with 147 episodes of bacteremia were detected among 945 newborn admissions. The most common isolates in blood cultures were grampositive cocci (55%). Clinical findings associated to sepsis were non-specific. Premature infants presented apnea and jaundice more frequently than term infants (p < 0.05). At diagnosis of sepsis, 19% of premature infants had a normal CBC compared to 8% of term infants. Leukopenia was a poor prognosis-related finding, i.e. seven out of 35 patients who died were leukopenic vs 1 of 68 survivors (p < 0.05). Overall, mortality was 34%, but sepsis-related mortality was 13%.


CONCLUSIONS
The incidence of sepsis in our population was high with grampositive cocci as the most common blood isolates. Clinical features associated to sepsis were non-specific. A significant proportion of septic preterm infants had normal CBC at diagnosis and leukopenia was a poor prognosis sign. Mortality associated to sepsis was high.