Sepsis Flashcards
What is the definition of neonatal sepsis?
Systemic bacterial infection documented by a positive blood culture.
What is the incidence of early onset bacterial infection in term infants?
Occurs in 1-2/1000 term infants.
What is the incidence of early onset bacterial infection in very low birth weight infants?
Up to 24%.
What is the mortality rate of early onset sepsis in premature infants?
3% to 54%.
What is the risk of meningitis in infants with neonatal sepsis?
Highest in the first month of life; 40% of survivors have neurologic sequelae.
What is the time frame for early onset sepsis to present?
At or before 72 hours of age.
What percentage of early onset sepsis cases present in the first 24 hours after birth?
85%.
What are the most common organisms causing early onset neonatal sepsis?
- Group B Strep * E. Coli
What is the time frame for late onset sepsis?
Occurs from 72 hours to 7 days or later.
What are common organisms involved in nosocomial infection for late onset sepsis?
- Coag negative Staph * Pseudomonas * Enterococcus * E. Coli * Enterobacter
Name at least three maternal risk factors for neonatal sepsis.
- Malnutrition * Sexually transmitted disease * Periodontal disease
Risk of infection for GBS postive mothers
1% risk of infection if untreated.
Increased if preterm labor, maternal fever, prolonged ruptured membranes
What are some peripartum risk factors for neonatal sepsis?
- Untreated maternal infection * Rupture of membranes > 24 hours
List at neonatal risk factors for sepsis.
Prematurity
Low birth weight
Male infant
Meconium stained amniotic fluid
Need for resuscitation
Invasive procedures, lines, tubes
Formula feeding
What is a significant environmental risk factor for neonatal sepsis?
Hospital/NICU admission.
Why are neonates at increased risk for infections? (3)
- Decreased cytokine production * Decreased antibody levels * Poor response to antigen stimulation *Decreased size of neutrophil storage and proliferative pools
*Reduced numbers of immature neutrophils in storage pool
What are common clinical presentations of neonatal sepsis?
- Respiratory distress * Apnea * Lethargy * Temperature instability
What laboratory evaluations are used for neonatal sepsis?
- CBC with differential * Blood culture * Urine culture * CSF
What is the gold standard for diagnosing infection in neonatal sepsis?
Isolation of pathogen in a blood culture.
What is the importance of obtaining a minimum of 1 cc of blood for culture?
For accurate culture results.
What common gram-positive bacteria can cause neonatal sepsis? (3)
- Streptococcus * Staphylococcus * Listeria
What is the treatment for Streptococcus Group B Beta hemolytic infections?
Treated with Ampicillin and Gentamicin.
What is a major cause of neonatal sepsis and pneumonia?
Streptococcus Group B Beta hemolytic.
What are the common pathogens for late onset sepsis?
- E. Coli * Klebsiella * Pseudomonas * Enterobacter
