1. بسم الله الرحمن الرحيم Neonatal Sepsis BKTH Department of Pediatrics Dr. magdah & Dr. Amal Unite April 2010 By: Dr. Mohamed Eisam Elhag Mahmoud MBBS, Alneelain University Faculty of Medicine Note: Dr. Mohammed Isam Al-Hajj does not have any financial relationships to disclose nor will he discuss any non-approved drug or device uses.
2. Babies and Bacteria... What will I learn ? Pathology * Causes * Symptoms * Diagnosis * Treatments
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7. Early onset sepsis Late onset sepsis Pathogens Group B Streptococcus E. coli Haemophilus influenzae Listeria Virus, STD Coagulase negative staphylococcus Staphy. aureus E. coli Klebsiella Pseudomonas Enterobacter Baby in risk Term, near-term baby Preterm baby
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10. pathogens can enter a neonate’s body in many ways ! Prenatal Maternal Substance Abuse Premature Rupture of Membranes (>18 Hours) Maternal Infection Perinatal Microbial Colonization at Birth Maternal Infection Vaginal Exam of Mother Postnatal Invasive Catheters Endotracheal Intubation Exposure to Nosocomial Microorganisms
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33. Treatment First five days. After first five days. Start ampicillin and gentamicin for 1.all VLBW neonates and 2. any infant who --Appears septic or is sicker than would be usually anticipated. --Has any vascular catheter Start amoxycillin and cefoxitin in all other babies Start vancomycin and amikacin in all babies (Almost all Coag negative Staph is sensitive to Amikacin but resistant to gentamicin. ) ( Flucloxacillin being used at present because of an increased number of Staph aureus isolates within the unit ) Add amoxycillin if specific cover for Enterococci, Strep fecaelis [suspected NEC], Listeria or Group B Strep is needed.