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단일기관 응급실에서 침습적 B군 사슬알균감염으로 진단된 90일 미만 영아의 임상적 특성

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Alternative Title
Clinical characteristics of infants younger than 90 days diagnosed with invasive group B streptococcal infection in the emergency department
Abstract
Purpose: We aimed to characterize invasive group B streptococcal infection (IGBSI) in young infants hospitalized through the emergency department.
Methods: We analyzed medical records of infants younger than 90 days with IGBSI, defined as group B streptococcus bacteremia or meningitis, who visited the emergency department from January 2009 through December 2021. Their clinical features were compared as per 2 criteria, neonates and meningitis. For the comparisons, we defined 2 composite outcomes, “clinically important abnormality (any of the followings: temperature > 38.5。C, leukocytes < 5,000/mm3 or > 15,000/mm3, absolute neutrophils > 4,000/mm3 or C-reactive protein > 2.0 mg/dL)”and “poor outcomes (any of the followings: intensive care unit, transfer, seizure or complications).”Percentages are rounded to the first decimal places.
Results: A total of 35 infants, of whom 15 (43%) were neonates and 17 (49%) were boys, had IGBSIs, including 23 infants (66%) with isolated bacteremia, 11 (31%) with bacteremia with meningitis, and 1 (3%) with isolated meningitis. Ill appearances were noted in 27 infants (77%) who encompassed all with meningitis. The other 8 infants (23%) looking well had 1 or more components of the clinically important abnormality. The neonates showed a higher frequency of vaginal delivery (87% vs. 35%; P = 0.002) and a lower frequency of a temperature > 38.5℃, compared to their counterparts (47% vs. 80%; P = 0.040). The infants with meningitis had a longer median time required to visit (5.0 vs. 2.0 hours; P = 0.011), and higher frequencies of ill appearance (100% vs. 65%; P = 0.032), leukocytes < 5,000/mm3 (67% vs. 13%; P = 0.002), and the poor outcomes (75% vs. 0%; P < 0.001).
Conclusion: Young infants with ill-looking appearance or abnormality in any of the fever or inflammatory markers may have IGBSIs, particularly meningitis.
Author(s)
김미진오기원
Issued Date
2023
Type
Article
Keyword
Bacterial InfectionsEmergency ServiceHospitalFeverInfantNewbornStreptococcus agalactiae
DOI
10.22470/pemj.2022.00654
URI
https://oak.ulsan.ac.kr/handle/2021.oak/15854
Publisher
대한소아응급의학회지
Language
한국어
ISSN
2383-4897
Citation Volume
10
Citation Number
2
Citation Start Page
54
Citation End Page
59
Appears in Collections:
Medicine > Nursing
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