Abstract
BACKGROUND: To investigate the differences in clinical characteristics between Gram-positive and Gram-negative neonatal sepsis (NS). METHODS: A retrospective analysis was conducted on a total of 151 neonates admitted between March 2019 and March 2024. The 91 NS patients were divided into the Gram-negative bacteria group (n=31) and the Gram-positive bacteria group (n=60). Sixty (n=60) non-septic neonates served as controls, and general information was collected from all participants. C-reactive protein (CRP), procalcitonin (PCT) and platelets (PLT) were independent factors that influenced the differentiating infections caused by the two pathogens. The onset symptoms, strain distribution, and various biochemical parameters were compared before the treatment among the three groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy. RESULTS: The proportions of patients with amniotic fluid contamination and fever (body temperature ≥ 38.0 °C) were higher in the Gram-negative group than in the Gram-positive group (P=0.023, 0.049). The concentrations for CRP, PCT and PLT were P=0.019, 0.023, 0.030 respectively. ROC curve analysis revealed that the specificity of the combination of CRP, PCT and PLT in diagnosing Gram-negative bacterial infection was 100.00%, and the area under the curve (AUC) was 0.904, which was higher than those of single indicators (P=0.05). CONCLUSION: There are differences in the expression of CRP, PCT and PLT between Gram-positive and Gram-negative NS. The simultaneous detection of the three has a high diagnostic value in differentiating infections caused by the two pathogens.