sepsis in infants r

Question 1

risk factors for sepsis in newborns

Answer 1

maternal pyrexia or sepsis 
group B strep in maternal carriage 
prolonged rupture of membranes 
early membrane rupture 
prematurity

Question 2

what is the commonest cause of sepsis in newborns

Answer 2

group B strep

Question 3

how does GBS cause sepsis

Answer 3

GBS in vaginal canal is transmitted to the baby during vaginal delivery

Question 4

other causes of sepsis

Answer 4

e.coli
maternal sepsis
h influenzae
coagulase negative staphylcocci

Question 5

presentation of sepsis in newborns

Answer 5

usually non-specific 
most common presentation is tachypnoea 
poor feeding 
pyrexia or hyperthermia 
lethargy or irritability 
hypo or hyperglycaemia 
floppy

Question 6

what babies are treated with extra caution

Answer 6

2+ risk factors
or
1 red flag symptom

Question 7

red flag symptoms

Answer 7

confirmed or suspected sepsis in mothers
signs of shock
seizures
term baby that needs mechanical ventilation
resp distress starting 4+ hours after birth

Question 8

partial septic screen

Answer 8

FBC
CRP
blood culture
blood gas

Question 9

other investigations that can be done in sepsis

Answer 9

CXR for pneumonia

LP if meningitis

Question 10

initial management in babies with suspected sepsis

Answer 10

dont wait for a diagnosis - have a very low threshold of treatment/suspicion
take bloods and give antibiotics

Question 11

1st line antibiotics

Answer 11

penicillin and gentamicin

Question 12

2nd line antibiotics

Answer 12

vancomycin and gentamicin

Question 13

what antibiotic can you use if you have surgical or GI concerns

Answer 13

metronidazole

Question 14

when can you stop treatment

Answer 14

after 2 negative blood tests and if CRP is less than 10