Septicemia Neonatorum
 |
| Septicemia Neonatorum |
- Septicemia is the systemic invasion of pathogenic bacteria into the bloodstream . in the newborn it is known as sepsis neonatorum.
- It is a generalized infection, which may occur in the neonate and is characterized by the proliferation of bacteria in the bloodstream and frequently involves the meninges.
Incidence:
- 1 in 1000 live full term births.- 1 in 250 live premature births.
Aetiology:
The distribution of etiologic agents varies from year to year and from institution to another.1. Common offending organisms:
- E.coli.
- Listeria.
- Klebsiella.
- Group b hemolytic streptococci.
- Staphylococcus aureus.
- Pseudomonas.
- Hemophilus influenza.
2. Infective source and route of transmission:
Transplacental assault.
Aspiration of meconium.
Contact with an infectious agent during descent through the birth canal.
- Aspiration of infected amniotic fluid.
- Infected infants.
- Nursery personnel or equipment.
3. Portal of entry may be nasopharynx, skin, eye and umbilicus.
4. The infant's body unable to localized infection.
5. Pathogenic bacteria multiply, infection spreads and bacteria migrate into systemic circulation.
Predisposing factors:
- Sex ( male predominance ).a. Maternal complication e.g. prolonged rupture membranes, prolonged and difficult labour, UTI, endometritis, chorioamnionitis, maternal illness, abruptio placenta …
b. Infant complication e.g. prematurity, low birth weight congenital heart disease, RDS, skin infections.
- Environmental factors e.g. unclean equipment, surgical procedures, obstetric and nursery practice …
Complications:
- Meningitis and neurological damage.- Shock.
- Pneumonia.
- Congestive heart failure.
- DIC.
- High mortality rate.
Assessment:
1. Clinical Presentation:a. signs and symptoms:
The early signs and symptoms of sepsis usually vague and subtle. the infant is often described as not doing well. the sign often includes poor feeding, gastric retention, lethargy, meconium stained and temperature alternation, usually hypothermia but may have hyperthermia.
later signs and symptoms: may include: pallor, cyanosis, apneic episodes, jaundice, abdominal distention, vomiting, diarrhoea, hypotonia, fever or/and irritability or seizures.
b. History of predisposing factors.
2. Physical Findings.
3. Laboratory: Recovery of the organism from blood cultures must be obtained for a diagnosis of sepsis neonatorum.
a.) Cultures to detect specific organism include blood, urine, umbilical stump, skin lesion, nose throat, rectum, CSF and gastric fluid.
b.) WBCs and differential.
Blood chemistry.
Hb and HCT.
Blood- gas analysis.
TORCH.
Bilirubin.
4. Urine Analysis.
Treatment:
1- Anti bacterial: according to culture and sensitivity.2- Supportive therapy:
- Observation.
- Isolation.
- Oxygen therapy.
- Fluid and caloric maintenance.
- Regulation of thermal environment.
READ MORE:
Iron deficiency anemia in pregnancy
Nutrition Risk Factors In Pregnancy
Post A Comment:
0 comments so far,add yours