INFECTION IN NEONATE.pptx

7/23/2019 INFECTION IN NEONATE.pptx

1/28

INFECTION IN

NEONATE

Reproductive SystemPerinatology Division, Child Heath Department,

Medical Faculty of Hasanuddin University


2/28

Infection in neonateccording to timing of

transmission!Congenital Infection

"eonatal infection

ccording to severity!

Mild infectionSevere infection "eonatal

Sepsis


3/28

#iming oftransmissio

n

"$%"#& I"F$C#I%"CONGENITAL INFECTION

Route ofinfection

#ime ofpresentatio

n Month or yearslater

First fe' 'ee(s oflife!

)$arly onset ! *+h

)&ate onset ! - +h

t .irth ormonth/year later

#ransplacental / .irthcanal / .reastmil(

#ransplacental

Shortly .efore or atdelivery or post natally

In) utero

Viral Others

CM0Ru.ella

Parvovirus010

#o2oplasmosisSyphilisMalaria

#3

Bacterial Viral Fung

al

) 4rouo 3streptococcus) 4ram 5)6organism) &isteriamonocytogenes

) Coagulasenegative Staph7ureus

HS0010$nterovirus

HIVHepatitisBHepatitisCHPVHTLV-1


4/28

Congenital Infection

May precipitate a.ortion, still.irth or preterm delivery

Head !

Intracere.ral calci8cation

Hydrocephalus

Microcephalus

$ye!

Cataracts

Microphthalmia Retinitis

$ar ! Deafness

Heart defect! Cardiomegaly,PD

Pneumonitis

Splenomegaly

Hepatomegaly

9aundice

nemia, "eutropenia,#hrom.ocytopenia

3one a.normalities Rash

IU4R

Clinical Features


5/28

ANTENATAL POSTNATAL

Maternal- Histr! "rash# cntact$

- Screening serlg!-sercn%ersin "Ig IgM# IgA$

- Culture'PC( ) lessin e*g*cer%ical herpes# +l,# urine

Fetal-ltrasun, scanning )ran.alies-

A.nicentesis )rserlg!'culture'PC(

Placenta-Histologi/microscopic-Culture/PCR

In)ant) Culture/PCR! .lood, urine, CSF,stool, nasopharyngeal aspirate,s(in lesion

Diagnosis


6/28

"eonatal InfectionClassi8cation!

Severe Infection Sepsis$arly onset Sepsis 5*+ hours6

&ate %nset Sepsis 5-+ hours6

Mild infection! S(in, eye, um.ilical, mouth, etc


7/28

#iming of

transmission

"$%"#& I"F$C#I%"

Route ofinfection

#ime ofpresentatio

n

Month or yearslater

"osocomial3irth canal

#ransplacentalChorioamnionitis

3irth canal

3irth canal"osocomial3reastmil(

$arly onsetsepsis 5*+

hours6

Shortly .efore or at delivery or postnatally

HIVHepatitisBHepatitisCHPVHTLV-1

&ate onsetsepsis 5-+

hours6

Bacterial

- &ru Bstreptcccus- &ra. "-$ rganis.-Listeria.nc!tgenes-Staph!lcccus Aureus

TE(M P(ETE(M

) 4rouo 3

streptococcus-4ram 5)6organisms

-Coagulase

negativeStaphylococcus5C%"S6-4ram 5)6organisms-4roup 3streptococcus-Staphylococcusureus-$nterococcus


8/28

Infections 32%

Asphyxia 29%

Complications of prematrity 2!%

Con"enital anomalies #$%

Other %

Case fatality &e to neonatal sepsis is 12 to 68% in

&e'elopin" contries

"eonatal

Mortality


9/28

"eonatal sepsis) mor.idity

(rain &ama"e &e to

menin"itis) septic shoc*) or

hypoxemia

Other or"an &ama"e + ln")

li'er) lim,s) -oints


10/28

$arly %nset Sepsis ) ris( factors

.aternal chorioamnionitis

/rolon"e& rptre of mem,ranes 0#1 h

Fol smellin" amniotic fli&

an&lin" ,y ntraine& mi&ife

.aternal rinary tract infection

/rematre la,or


11/28

Chorioamnionitis.aternal fe'er &rin" la,or 314C

5 terine ten&erness

5 lecocytosis

5 fetal tachycar&ia

High risk of neonatal sepsis


12/28

&ate %nset Sepsis )ris( factors

/rematrity6 L(7

In hospital

In'asi'e proce&res+ 'entilator) I8 lines) central

lines) rine catheter) chest t,e

Contact ith infectios &isease + &octors) nrses)

,a,ies ith infections)Not fe& maternal ,reast mil*

POOR HYGIENE in NICU


13/28

(acterial /atho"ens esponsi,le for :epsis in

;e'elopin" Contries

Earl onset sepsis

Gram ne"ati'e ,acilli

E


14/28

Diagnosis of "eonatalSepsis

Clinical si"ns an& symptoms

La,oratory tests

cltre of ,acterial patho"en

other la,oratory in&icators

a&iolo"ic


15/28

Clinical si"ns an& symptoms

Clini"al #igns$ early si"ns non+ specific) may ,e s,tle

espiratory &istress+ &%

Apnea

Temperatre insta,ility+ temp more common

;ecrease& acti'ity

Irrita,ility

/oor fee&in"

A,&ominal &istension

Hypotension, shock, purpura, seizures- late signs


16/28

La,oratory Tests

Cltres to i&entify ,acterial patho"en

,loo&) C:F) rine) other

ematolo"ical tests

7(C cont >normal


17/28

Lm,ar /nctre

/ossi,ility of menin"itis #+#$%

(a,ies ith menin"itis may not ha'e specific symptoms

1'% of (a(ies )ith *eningitis )ill ha+e negati+e

(loo, "-lt-res


18/28

First line therapy

Ampicillin $ m"6 *"

e'ery #2 hors in #st ee* of lifee'ery 1 hors from 2+ ! ee*s

P!U#

Gentamicin once &aily+@

R. $

Isolation

Eye Topical A


25/28

25

E6 B :taphylococcs ares

yperemic) e&ema) ex&ate

:e'ereli"< falciformemltiple a,scess

Chronic"ranlom

R. $

Topical B A


26/28

26

Thrsh patches in the ,a,ys moth) lips) ton"e

//.remain mil*easy to remo'e

E.fn"s B Can&i&a al,icans

If B + immnocompromie

+ Hsin" A


27/28

27

/.B se&iaan hapsmycellim spora

R. $

Gentian 'iolet $ ? ? # %

(orax "licerin

Nistatin soltion 3 x #$$


28/28

#H";

INFECTION IN NEONATE.pptx

Documents