slides on neonatal sepsis, health and medicine homework help

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slides on neonatal sepsis

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NEONATAL SEPSIS
GIDEON KOLESH MED 6

Objectives



Define early and late onset sepsis
Describe the pathogens that occur in early
and late onset sepsis



Describe the risk factors for neonatal sepsis



Create a differential for neonatal sepsis



Describe the workup for neonatal sepsis



Know empiric treatment for neonatal sepsis

Introduction





Neonatal sepsis is a clinical syndrome
of systemic illness accompanied by
bacteremia in the first month of life

Neonatal sepsis is a common cause of
morbidity and mortality

Importance




Neonatal sepsis is the single most
important cause of neonatal deaths in
the community, accounting for over
half of them

If diagnosed early and treated
aggressively with antibiotics and good
supportive care, it is possible to save
most cases of neonatal sepsis.

Classification


Early Onset Sepsis (EOS):
– Culture proven infection within the first
72 hours of life



Late Onset Sepsis (LOS):
– Culture proven infection after 72 hours of
life
– Sepsis, UTI, pneumonia, meningitis,
osteomyelitis, NEC

Incidence






1-5/1000 live births in developed
countries
6-23/1000 live births in developing
countries
Higher incidence of neonatal sepsis in
VLBWs



2% infection in utero



10% infection in the 1st month of life



Mortality rate is high (13-25%)

Risk factors


Maternal










Prolonged/premature ROM (>18 hrs)
Maternal GBS colonization
Chorioamnionitis
> 6 digital VE during labor with PROM
Poor or no ANC
Intrapartum asphyxia
Maternal infection I.e. UTI
Toxemia



Fetal/Neonatal










Prematurity
Male sex
Twinning – esp 2nd twin
Galactosemia
Low apgar score = asphyxia
Omphalitis
Developmental/congenital immune defects
Congenital anomalies i.e. of urinary tract



Environmental





Poor delivery techniques
Congestion of newborn units
Improper sanitation
Sick staff around newborns

Etiology: EOS


Early Onset Sepsis (EOS):
– Group B Streptococcus (GBS)
– E. Coli
– Listeria monocytogenes
– Streptococcus species ie. Viridans
– H. influenza
– N. gonorrheae, C. trachomatis, TB



Due to maternal or perinatal factors

Etiology: LOS


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