Microbiology 9S: Neonatal and Childhood Infections Flashcards
Which neonatal imfections are screened for routinely during pregnancy?
- Hep B
- HIV
- Rubella status (NOT THE INFECTION ITSELF)
- Syphilis
Which neonatal infections are currently not screened for, but can be?
- CMV (most common cause of congenital deafness in the UK)
- Toxoplasmosis
- Hep C
- Group B Streptococcus (mother is screened only if asymptomatic bacteriuria)
What are some common clinical features of neonatal infection?
What is the lifecycle of toxoplasmocosis?
- Acute infection will start off in a cat
- It produces faeces containing oocysts
- Mice and birds eat the faeces
- Cats eat birds and mice
- This ends up becoming a cycle
Is congenital toxoplasmocosis symptomsatic at birth?
may be asymptomatic (60%) at birth
What are the long term sequale of congential toxoplasmocosis?
- Deafness
- Low IQ
- Microcephaly
If the baby shows symptoms of congential toxoplasmocosis at birth, what are they?
- 40% of babies are symptomatic at birth (4 C’s)
- Choroidoretinitis
- Microc**ephaly/hydro**cephalus
- Intracranial calcifications
- Seizures / convulsions
- Hepatosplenomegaly/jaundice
Which is the main factor affecting Congenital Rubella Syndrome’s effect on the foetus?
time of infeciton (during pregnancy)
What is the mechanism of Congenital Rubella Syndrome?
- Mechanism: mitotic arrest of cells, angiopathy, growth inhibitor effect
What is the classic triad of features of Congenital Rubella Syndrome?
- Cataracts
- Congenital heart disease (PDA; ASD/VSD)
- Deafness/SNHL
What are some other features of Congenital Rubella Syndrome?
- Microphthalmia
- Glaucoma
- Retinopathy
- ASD/VSD
- Microcephaly
- Meningoencephalopathy
- Developmental delay
- Growth retardation
- Bone disease
- Hepatosplenomegaly
- Thrombocytopaenia
- Rash
What are the features on the child of congenital Herpes Simplex Virus?
- This can spread to the neonate through the genital tract –> blistering rash
- It can cause disseminated infection with liver dysfunction and meningoencephalitis
When is Chlamydia trachomatis transmitted to the child?
during delivery
If the mother has Chlamydia trachomatis, is she always symptomatic?
no can be asymptomatic
What can Chlamydia trachomatis cause in the neonate?
neonatal conjunctivitis or pneumonia (RARE)
What is the Tx for Chlamydia trachomatis?
erthryomycin
Name some other congenital infections
- Hep B and C
- HIV
- Listeria monocytogenes
- GBS
- Syphilis
- Mycoplasma species
- Parvovirus
When is the neonatal period?
first 4 weeks of life
How does the neontal period timings differ for a premature child?
- If born premature, the neonatal period is longer and is adjusted for the expected birth date
Why are premature children at greater risk of infection?
- Premature neonates are at INCREASED risk because:
- Less maternal IgG
- NICU care
- Exposure to micro-organisms, colonisation and infection
What is the first, immediate step of Tx for a suspected infection in a neonate?
treat with ABx as soon as infection is suspected!
What is the timing for the term ‘early onset’ neonatal infection?
within 48 hours (or 3 to 5 days; definitions vary) of birth
Name some possible early onset neonatal infections
- Group B Streptococcus
- Escherichia coli
- Listeria monocytogenes
- Early-Onset Sepsis
*
Name some features of Group B Streptococcus
- Lancefield Group B
- Gram +ve coccus
- Catalase -ve
- Beta haemolytic
- 33% of women have GBS commensal (gut, urinary tract, etc)
What is the function of a catalase test?
The catalase test is primarily used to distinguish among Gram-positive cocci:
- members of the genus Staphylococcus are catalase-positive
- members of the genera Streptococcus and Enterococcus are catalase-negative.
What is the clinical significance of beta haemolytic bacteria?
can completely lyse RBCs vs non-beta haeemolytic bacteria
What does Group B Streptococcus infection cause in neonates?
- Bacteraemia
- Meningitis
- Disseminated infection (i.e. joint infection)
What are some features of E Coli?
- Gram -ve rod
- The K1 antigen is particularly problematic
What does E coli cause in neonates?
- Bacteraemia
- Meningitis
- UTI