Neonatal Infections Flashcards
What is GBS?
gram positive cocci in pairs or chains
what is enterococcus?
gram positive cocci in chains
- nosocomial
- present as bacteremia, meningitis, and UTI
what is staphylococcus?
gram positive cocci in clusters
what is staph coag positive?
staph aureus
-scalded skin syndrome, MRSA
what is staph coag negative?
staph epi
what is e. coli?
gram negative rod
-associated with chorio
what are the space bugs that need double coverage?
Serratia Pseudomonas Acinetobacter Citrobacter E. coli
what is klebsiella?
gram negative rod (second most common)
- frequent cause of pneumonia especially w/ventilator
- can produce extended spectrum beta-lactamases which are resistant to penicillins, cephalosporins, and some ahminoglycosides
most common types of candida
albicans and parapsilosis
-malassezia furfur requires special plating
congenital candida sepsis
- related to ascending infection in utero
- presents shortly after birth
- full term is generalized rash
- preterm has rash, pustules, vesicles, invasive pulmonary disease
systemic candida
- if infant is deteriorating and not responding to treatment, consider antibiotic change or fungal source!
- renal involvement is common (do US)
- thrombocytopenia
- hyperglycemia
herpes simplex mode of transmission
- congenital (4%): triad is brain, eye, skin
- perinatal (86%): typically vertical from mom to baby during delivery process is most common
- postnatal (10%)
primary vs secondary HSV infection
-primary infection much worse: more viral shedding and less IgG to fight it
three presentations with HSV
- disseminated
- skin, eye, mouth
- CNS
disseminated HSV
- most lethal, multiorgan involvement
- earliest presentation (within first five days of life)
- 10-50% have NO lesions
SEM HSV
- most common
- localized form, limited to skin and mucus membranes
- clustered, reddened, erythromatous base with pustule
- presents with lesions 1 week or later, not at birth
- remove roof and culture lesion
- if untreated, will progress to disseminated or CNS disease
CNS HSV
- latest presenting form (DOL 10-18)
- initially may have subtle, nonspecific findings
- seizures
- abnormal LP
about CMV
-most common congenital infection worldwide
CMV transmission
- transplacental and intrapartum: maternal infection first half of pregnancy associated with greater risk of neonatal infection and greater severity
- breast milk (freeze milk for VLBW)
CMV presentation
- IUGR
- jaundice
- HSM
- purpura
- blueberry muffin rash
- microcephaly
- periventricular calcifications and chorioretinitis (ophtho needs to look at eyes)
CMV diagosis
-send urine culture
CMV sequelae
- mortality
- 10-20% major neurodevelopment problems: DEAFNESS, visual impairment, cognitive delays, spastic quadriplegia
- increased risk for dental caries
about VZV
- congenital infection is rare
- mild to severe neonatal disease that presents before DOL 10: CNS abnormalities, limb abnormalities, and skin lesions
most concerning mode of transmission for VZV
-maternal onset between 5 days prior to delivery until 2 days after delivery: infant is exposed and born before the mom can transfer immunity via the placenta
