neonatal sepsis Flashcards
define neonatal sepsis
serious bacterial or viral infection in the blood affects babies within the first 28 days of life
accounts for 10% of ALL neontal mortality
how is neonatal sepsis split 2
early onset - within 72 hrs of birth
late onset -between 7 and 28 days of life
risk factors for neonatla sepsis
preterm birth
black race- BUT ONLY FOR GORUP-B STREP RELATED SEPSIS
causes of early onset neonatal sepsis 2
group B step - majority (75%)
otherwise E.Coli
causes of late onset neontal sepsis 5
occur via transmission from enviroment post-delivery from contact w parents or healthcare workers
staph epidermidis
pseudomonas aeruginosa
klebsiella
enterobacter
fungal species
(less common - staph A, entoeroccus, listeria moncytogens, viruses like herpes or enterovoirus
risk factors for neonatal sepsis 8
mother with:
-previous baby with GBS infection
-currently colonised w GBS in prenatal screening
-intrapartum temp >38 degrees
-membrane rupture >18hrs
-current infectoin throuhgout pregnancy
premature (<37wks)
low birth weight (<2.5kg)
eviedence of maternal chorioamnionitis
presentation of neontal sepsis 11
subacute onset of respiratory distress
-grunting
-nasal flaring
-use of accessory respiraotry muscles
-tachypnea
tachycardia
apnoea
change in mental state/lethergy
jaundice
seizures (if cuases of sepsis is menigitis)
reduced feeding
abdo distension
vomiting
temperature (not reliable)
temperature in neonatal sepsis dependent on gestation at birth
not reliable
term infants more likely to be febrile
preterm more likely to be hypothermic
investigation for neonatal sepsis 6
blood cultues
full body exam
crp
blood gas -metabolic acidosis
urine microsocpy culutre and sensiitivity -rarely postiive in early onset but usueful in late onset
lumbar puncture
signs of urine infection on testing in neonatal sepsis
raised leukovytes
postive culture
haematurie
proteinuria
signs of urine infection on testing in neonatal sepsis
raised leukovytes
postive culture
haematurie
proteinuria
ABx managemnt for neontal sepsis 2
early identificatoinand treatment is vital
- use IV benzylpenicillin with gentamicin
points about ABx managemnt in neonatal sepsis 3
give benzyl and gent
unless theres local resistance then consider other ABx
check CRP 18-24hrs after presentation
- if CRP <10mg/l at 48hrs and a negative culture at both presentationa and 48hrs then ABx can be ceased
usually ABx given for 10 dyas but follow specialist advice
other management aspects of neonatal sepsis other than ABx 4
maintain O2 status
maintain normal fluid and electrolyte status
-severely ill may need vasopressors
prevent/manage hypoglycaemia
prevent/managent metabolic acidosis
