Neonatal Sepsis

Posted by e-Medical PPT Thursday, July 22, 2010
Neonatal sepsis is invasive infection, usually bacterial, occurring during the neonatal period. Signs are multiple and include diminished spontaneous activity, less vigorous sucking, apnea, bradycardia, temperature instability, respiratory distress, vomiting, diarrhea, abdominal distention, jitteriness, seizures, and jaundice. Diagnosis is clinical and based on culture results. Treatment is initially with ampicillin plus either gentamicin or cefotaxime, narrowed to organism-specific drugs as soon as possible.
Neonatal sepsis can be early onset (within 7 days of birth) or late onset (after 7 days).Group B streptococcus (GBS) and gram-negative enteric organisms (predominantly Escherichia coli) account for most cases of early-onset sepsis.Nontypeable Haemophilus influenzae sepsis has been increasingly identified in neonates, especially premature neonates.
Late-onset sepsis is usually acquired from the environment.Staphylococci account for 30 to 60% of late-onset cases and are most frequently due to intravascular devices (particularly umbilical artery or vein catheters).E coli is also becoming increasingly recognized as a significant cause of late-onset sepsis, especially in very LBW infants.
Certain viral infections (eg, disseminated herpes simplex, enterovirus, adenovirus, respiratory syncytial virus) may manifest as early-onset or late-onset sepsis.
Certain maternal perinatal and obstetric factors increase risk, particularly of early-onset sepsis, such as the following:Premature rupture of membranes (PROM),Maternal bleeding (eg, placenta previa, abruptio placentae),Preeclampsia,Precipitous delivery,Maternal infection  and Preterm delivery.
The most common risk factor in late-onset sepsis is preterm delivery. Others are Prolonged use of intravascular catheters,Exposure to antibiotics,Prolonged hospitalization and Contaminated equipment or IV or enteral solutions.

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