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Neonatal Pathophysiology > Bacterial Infections > Flashcards

Flashcards in Bacterial Infections Deck (101)
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What is the definition of colonization?

presence of bacteria on a body surface (ex: skin, mouth, intestines, airways, etc), but the presence of bacteria does not cause disease in a person


What is the definition of infection/sepsis?

result of bacteria causing an illness, the s/s of infx depend on where the infx is


What is the definition of septicemia?

a serious, life threatening problem caused by a bacterial organism in the blood


What is the incidence of bacterial infections in the newborn?

1-8:1000 live births


What is the mortality rate for neonatal bacterial infx?

as high as 40% for preterm infant (early onset)


The significant mortality of neonatal sepsis necessitates what action by the provider?

early detection and treatment of sepsis to optimize the prognosis


What are common risk factors for neonatal bacterial infx?

PPROM, PROM >18h, PTL, chorioamnionitis, recent maternal infx, maternal fever in the perinatal period, maternal GU tract infx (including UTI and STD), perinatal asphyxia and invasive procedures


What is chorioamnionitis?

dx made by constellation of clinical symptoms including: maternal temp >100.4, maternal HR >100bpm, fetal HR >160bpm, uterine fundal tenderness, foul smelling amniotic or vaginal discharge, purulent appearing amniotic fluid


How does perinatal asphyxia increase an infant's risk for bacterial infx?

increased especially with PROM >18h, during asphyxial event, baby may gasp and deeply inhale infected amniotic fluid


What invasive procedures increase an infant's risk for bacterial infx?

procedures prior to del that interfere with the integrity of the amniotic cavity- CVS, amnio; or during delivery- fetal scalp electrode, vacuum assistance; or after delivery- PIV insertion, central lines, intubation


What is Gram staining?

the first step in identifying an organism, allows for differentiations of bacteria into 1 of 2 categories; G+ appear purple/blue (retain the stain) and G- appear pink


What are some common seen Gram positive bacterial organisms in the NICU population?

coagulase-negative staphylococcus, staphylocccus aureus, listeria monocytogenes, streptococcus pneumoniae and group A streptococcus


What are some common seen Gram negative bacterial organisms in the NICU population?

neisseria meningitdies, haemophilus influenza, klebsiella pneumoniae, pseudomonoas aeruginosa, acinetobacter species, citrobacter species, enterobacter species, serratia marcescens and proteus species


What is early onset sepsis?

within the first 72 h of life; can begin in utero as resul of swallowing or inhaling infected amniotic fluid; usually present within the first 24-48h


What is late onset sepsis?

after the first 72h of life


What are commonly presenting signs of bacterial infx in neonates?

respiratory distress, temperature instability, feeding intolerance, cardiovascular signs, abnormal neurologic status and abnormal skin findings * many of these signs may also be present with other concurrent illnesses


What clinical presentation of the respiratory system would indicate bacterial infx?

tachypnes, G/F/R, apeana, cyanosis, development/increased supplemental O2 requirement, respiratory support


What clinical presentation of temperature would indicate bacterial infx?

more commonly hypothermia, could be hyperthermia; temperature lability


What clinical presentation of feeding intolerance would indicate bacterial infx?

increased gastric residuals, poor feeding patterns, vomiting


What clinical presentation of the cardiovascular system would indicate bacterial infx?

tachycardia, bradycardia, mottling, hypotension, pale or grey skin color


What clinical presentation of the neuro system would indicate bacterial infx?

irritable, lethargy, sleepiness, sz and hypotonia


What clinical presentation of the integumentary system would indicate bacterial infx?

omphalitis, blisters on the skin, swelling or redness of the soft tissue, cellulitis, necrotic skin lesions


What is a WBC?

fx to protect the body from infx; produced in the bone marrow along with RBCs and platelets


What are the 5 different types of WBCs?

Neutrophils, eosinophils, basophils, lymphocytes and monocytes


What are neutrophils primarily responsible for?

killing and digesting bacteria


What are mature neutrophils called?

segmented neutrophils- segs (has a segmented nucleus), polymorphonuclear (PMNs), neuts, polys


What are immature neutrophils called?

bands, juveniles and stabs


How does a neutrophil mature?

in the bone marrow from a myeloblast into a segmented neutrophil


What comprises the neutrophil storage pool?

in the bone marrow the metamylocytes, bands and segmented neutrophils


How does the neutrophil storage pool of a neonate differ from an adult?

significantly smaller per kg of body weight