Neonatal Sepsis Flashcards
Why are neonates relatively immunocompromised?
Low levels of IgG (decreases with gest age)
Neutrophils - are not functional, also macrophages
Timing of neonatal infections
Early - Birth to 3 days - from maternal genital tract
Late - 4 days to 30 days
Late Late - >30 days to 3 months
Congenital sepsis - infections?
CMV
Syphilis
Rubella
Enteroviruses
GBS
HIV
Toxo
HSV
Neisseria Gonorrhoea
Late onset sepsis in neonate - common pathogens?
- staph aureus, Coag negative staph, group B strep - more common in developed
-Gram negatives (much more likely to die from this) - more common in developing
-Fungal!
Most important gram negative organism causing neonatal sepsis? (two)
Klebsiella
Ecoli
Most common gram positive organisms causing neonatal sepsis?
Staph aureus (MAIN), coag neg staph (IF REMAINS IN HOSPITAL), group B strep, listeria
3 Main pathogens causing neonatal sepsis?
Klebsiella
Ecoli
Staph aureus (add in coag neg staph if not discharged)
Neonatal pneumonia cause of severe case?
Group B strep
Staph aureus
(Gram positives)
Causes of neonatal meningitis?
GBS
Ecoli
What to do if a neonate has neonatal meningitis?
Repeat LP at 48 hrs to confirm negative culture
(For gram negatives repeat at end of therapy)
Duration of Rx in neonatal sepsis?
2 weeks gram positive organism
3 weeks gram negative organism
If no organism - 3 weeks
Causes of cerebral abscess in newborn?
- Cronobacter sakasakii
(Enterobacter sakasakii) - Citrobacter diversus
- Serratia marcescens
Treatment of neonatal sepsis worldwide? What about if suspect meningitis?
Ampicillin plus gentamicin (early onset)
Ampicillin plus ceftriaxone alternative
If high suspicion of staph aureus/coag negative staph causing neonatal sepsis Rx?
Ampicillin + vancomycin (late onset)
If suspect or confirmed pseudomonas for neonatal sepsis, desired Rx?
Ampicillin + vancomycin +/-
ceftazidime/cefepime***
