Term
| Serious bacterial infections |
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Definition
| more common in neonatal period than during any other time in life |
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Term
| Risk of Sepis is high (in Neonates) |
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Definition
| ANY infection during this time period is treated as this until proven otherwise |
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Term
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Definition
Occurs within 0-7 days of birth;
High perinatal risk factors;
Source: Maternal genital tract;
Fulminant;
Moderate presence of meningitis |
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Term
|
Definition
Occurs beyond 7 days;
Possible perinatal risk factors;
Primary Source: environment;
Secondary Source: maternal genital tract;
Insidiuous progression;
Presence of Meningitis: High |
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Term
| Perinatal Risk Factors for Sepsis |
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Definition
prematurity;
low birth weight;
prolonged rupture of membranes (>18 hrs after "water-breaking");
maternal fever;
meternal urinary tract infection;
maternal Grp B Streptococcal colonization;
fetal distress;
perinatal asphyxia;
chorioamnionitis;
male gender;
low socioeconomic status;
exposures from home/hospital environment |
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Term
| Initial Clinical Presentation |
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Definition
Temp. instability - hyperthermia or hypothermia;
Respiratory:
- tachypnea, retractions, grunting, nasal flaring, apnea;
Feeding issues:
- poor suckling, vomiting, increased gastric residuals, abdominal distention, diarrhea;
CNS Dysfunction:
- lethargy, irritability, seizures;
Cardiovascular:
- tachycardia, bradycardia, cyanosis, pallor, hypotension;
Hematologic:
- bruising, petechiae, bleeding, jaundice |
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Term
| Initial Lab Studies in determining Neonatal Sepsis |
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Definition
Neutropenia (ANC <1800/mm^3);
Bandemia (increase in bands);
thrombocytopenia;
increased C-reactive protein (CRP) |
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Term
|
Definition
obtained PRIOR to start of empiric therapy;
REQUIRED:
- blood
- urine
- cerebral spinal fluid (CSF) |
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Term
|
Definition
| 2 most common causes of neonatal sepsis during EARLY ONSET |
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Term
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Definition
| less common, but VERY DANGEROUS bacterial cause of neonatal sepsis in EARLY ONSET |
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Term
| Coag-Neg Streptococci, Staph. aureus |
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Definition
| 2 common pathogens in LATE ONSET neonatal sepsis |
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Term
| General Treatment of Neonatal Sepsis |
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Definition
Start empiric therapy IMMEDIATLEY;
Large #'s of pts will not have "sepsis" & will be "ruled out" after cultures come back in 48-72 hrs |
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Term
| Tx of Early Onset Neonatal Sepsis |
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Definition
- cover GBS & Gram-Neg enteric orgs;
1) ampicillin
AND
2) An Aminoglycoside (gentamicin) OR a 3rd Gen. Cephalosporin (DO NOT use CEFTRIAXONE)
Treat for 10-14 days (unless sepsis is ruled out) |
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Term
| Tx of Late Onset Neonatal Sepsis |
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Definition
Treat the same: Ampicllin + AMG OR 3rd gen. cephalosporin x 10-14 days
UNLESS Coag-POS Staph is suspected:
If suspected, use Ampicillin AND vancomycin x 10-14 days (unless sepsis is ruled out) |
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Term
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Definition
1) Test mothers at 35-37 wks to determine carriers;
2) If test not performed, evaluated at time of delivery for risk factors;
3) If needed, preferred tx is PCN G 5 million units IV initially followed by 2.5 million units Q4H x 7-10 days |
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