[Study on septicaemia in infants and children in the past 20 years. Part 2. An analysis of factors that prescribe for the prognosis].
Underlying diseases, complications, clinical findings, and laboratory findings were evaluated in 158 cases of septicaemia admitted to Jikei University Hospital from 1975 to 1994, in order to conjectured factors that prescribe for the prognosis. 50% of the patients had underlying diseases. Malignancy including leukaemia (31 cases, 39.2%) was the most common underlying disease, followed by low birth weight infant (17 cases, 21.5%), aplastic anemia (9 case, 11.4%), and congenital heart disease (7 cases, 8.9%). The death rate for patients with underlying disease (27.8%) was significantly greater than the mortality for normal patients with septicaemia (8.9%) (p < 0.05). Meningitis (24.7%) was the most common complication, followed by DIC (19.6%), shock (15.2%), and pneumonia (10.8%). The mortality rate of septicaemia complicated by shock was 66.7% (p < 0.01), and that complicated by DIC was 45.2% (p < 0.01). The mortality rate for patients with the clinical findings of respiratory distress, cough, abdominal distention, cyanosis, splenomegaly, or peripheral coldness was more than 40% and significantly greater (p < 0.01). Mortality rate in patients with granulocyte counts of < 4.000/mm3, platelet counts of < 5 x 10(4)/ mm3, total protein of < 5.0 g/dl, or ESR of < 20 mm/hr were significantly greater (p < 0.01) than those in patients with normal laboratory findings. Coincidence rate of blood and stool cultures was 57.9% for E. coli, and 28.6% for Klebsiella sp., and that of blood and throat cultures was more than 30% for Pseudomonas sp., Haemophilus influenzae, and Staphylococcus aureus. In the study of antimicrobial susceptibility for microorganisms isolated, the number of drug resistant S. aureus had increased in the last 10 years.
Department of Pediatrics, kashiwa Hospital, Jikei University School of Medicine.
T
T
Sato
Y
Y
Wada
M
M
Okazaki
S
S
Kobayashi
N
N
Okabe
Y
Y
Eto
M
M
Kubo
K
K
Maekawa
D000293:Adolescent; D000741:Anemia, Aplastic; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation; D004926:Escherichia coli / Q000302:isolation & purification / Q000472:pathogenicity; D005163:Factor Analysis, Statistical; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007709:Klebsiella / Q000302:isolation & purification / Q000472:pathogenicity; D007938:Leukemia; D008581:Meningitis; D009369:Neoplasms; D011379:Prognosis; D018805:Sepsis / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity