Neonatal Sepsis Flashcards

1
Q

Defintion

A

Bacterial or viral infection in the blood within first 28 days of life.

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2
Q

Caterogies

A

Early-onset: 72 hours of birth
Late onset: 7 - 28 days

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3
Q

Aetiology

A

Early onset:
- Group b strep
- E.coli
Late onset:
- Staph epidermidis
- Pseudomonas aeruginosa
- Klebsiella
- Enterobacter
- Fungal causes

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4
Q

Risk factors

A
  • Mothers who has had a previous baby with GBS infection who has current GBS colonisation from prenatal screening, current bacteruria, intrapartum temperature ≥38ºC, membrane rupture ≥18 hours, or current infection throughout pregnancy
  • Premature (<37 weeks)
  • Low birth weight (<2.5kg)
  • Evidence of maternal chorioamnionitis
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5
Q

Presentation

A
  • Signs of resp distress
  • Tachypnoea
  • Apnoea
  • Jaundice
  • Seizures
  • Poor feeding
  • Abdo distention
  • Temperature
    = Term infants are more likely to be febrile
    = Pre-term infants are more likely to be hypothermic
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6
Q

Diagnosis

A
  • Blood cultures
  • FBC: abnormal neutrophil count
  • C-reactive protein
  • ABG: metabolic acidosis
  • Urine microscopy
  • Lumbar puncture: required as part of septic screen in any baby below age of 28 days
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7
Q

Treatment

A
  • FIRST LINE: IV BENZYLPENICILLIN + GENTAMYCIN
  • CRP should be remeasured in 18-24 hours after presentation
  • Maintaining adequate oxygenation status
  • Maintaining normal fluid and electrolyte status
  • Prevention and/or management of hypoglycaemia
  • Prevention and/or management of metabolic acidosis
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