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Neonatal  Septicemia Mbbs.weebly.com
Will They Have  Good  Future ???
Objectives What will I learn? Etiologies and risk factors Symptoms Diagnosis Treatment
Introduction   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
What is Neonatal Sepsis? ,[object Object],[object Object],[object Object],[object Object]
Some basic definitions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogen  ,[object Object],[object Object],[object Object],[object Object]
Staphylococcus
E. Coli
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[object Object]
Klebsiella
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Group B -hemolytic streptococcus
Route of Infection ,[object Object],[object Object],[object Object]
Sepsis Risk Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What makes a neonate’s immune system susceptible to sepsis? Maturity Immaturity or
You’re Right!!!! The immaturity of a neonate’s immune system makes them MORE SUSCEPTIBLE to sepsis.
Why are newborns so vulnerable to infection? Non-specific immunity Specific immunity
Why are newborns so vulnerable to infection? IMMUNE SYSTEM Neutrophils – Qualitative and quantitative Complement and immunoglobulin levels decreased T cells-  antigenically naïve limited cytokine production
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Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical menifestations EOS LOS Onset  Within 7 days >7 days Source Prenatal During delivery During delivery Postnatal(nosocomial )  Pathogens G - bacili S taphylococcus ; Opportunitic P resentation Mortality  P neumonia High Bacteremia and / or meningitis Low
Symptoms of Neonatal Sepsis The symptoms of are not  concrete  and vary widely   Tachypnea   Heart Rate Changes Feeding difficulties   Difficulty Breathing Temperature Instability       J aundice  Irritability
Omphalitis
Bleeding tendency Poor perfusion
Enlargement of  liver and spleen
toxical paralytic ileus
NEC
NEC
dyspnea
Clinical presentation Early warning signs are often  non-specific and subtle    easily confused with non-infective causes (e.g. apnea of prematurity, variation in environmental temperature or acute exacerbation of chronic lung disease)  clinical course alarmingly fulminant  septic shock + DIC  death   Non-specific, multi- systems/organs involved
Clinical  manifestation The symptoms are so  broad  ,  non-specific , and  acute deterioration ,  How to make a diagnosis as early as possible ?
Laboratory studies ,[object Object],[object Object],[object Object]
Laboratory Examination:  CBC ,[object Object],[object Object],[object Object]
Reference values for neutrophilic cells Manroe BL, J Pediatr 1979;95:89-98.
Total neutrophils Immature neutrophil I/T ratio
 
Lab examination:CRP ,[object Object],[object Object],[object Object]
Lab Exam:   Organism detection    blood culture    culture of body fluid and secretion    plasma brown layer smear --Detection of antigen: usually for antibody of GBS or E coli in CSF, blood and urine --Molecular biochemical method  PCR
Summary Is there a diagnostic marker  for neonatal sepsis?
Great answer! You’re correct! ,[object Object]
Summary ,[object Object],[object Object],[object Object]
Diagnosis   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Therapy ,[object Object],[object Object],[object Object]
Treatment    Antibiotics therapy  management of complications  supporting therapy  Clearance of infectious focus  Immunotherapy
Antibiotic therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dosages of antibiotics for newborns
Supporting therapy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of complications ,[object Object],[object Object],[object Object],[object Object]
Immunotherapy ,[object Object],[object Object],[object Object],[object Object]
Questions ,[object Object],[object Object]
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6 Neonatal Septicemia

  • 1. Neonatal Septicemia Mbbs.weebly.com
  • 2. Will They Have Good Future ???
  • 3. Objectives What will I learn? Etiologies and risk factors Symptoms Diagnosis Treatment
  • 4.
  • 5.  
  • 6.
  • 7.
  • 8.
  • 11.
  • 12.
  • 14.
  • 15. Group B -hemolytic streptococcus
  • 16.
  • 17.
  • 18.
  • 19. What makes a neonate’s immune system susceptible to sepsis? Maturity Immaturity or
  • 20. You’re Right!!!! The immaturity of a neonate’s immune system makes them MORE SUSCEPTIBLE to sepsis.
  • 21. Why are newborns so vulnerable to infection? Non-specific immunity Specific immunity
  • 22. Why are newborns so vulnerable to infection? IMMUNE SYSTEM Neutrophils – Qualitative and quantitative Complement and immunoglobulin levels decreased T cells- antigenically naïve limited cytokine production
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Clinical menifestations EOS LOS Onset Within 7 days >7 days Source Prenatal During delivery During delivery Postnatal(nosocomial ) Pathogens G - bacili S taphylococcus ; Opportunitic P resentation Mortality P neumonia High Bacteremia and / or meningitis Low
  • 28. Symptoms of Neonatal Sepsis The symptoms of are not concrete and vary widely Tachypnea Heart Rate Changes Feeding difficulties Difficulty Breathing Temperature Instability J aundice Irritability
  • 31. Enlargement of liver and spleen
  • 33. NEC
  • 34. NEC
  • 36. Clinical presentation Early warning signs are often non-specific and subtle  easily confused with non-infective causes (e.g. apnea of prematurity, variation in environmental temperature or acute exacerbation of chronic lung disease)  clinical course alarmingly fulminant  septic shock + DIC  death Non-specific, multi- systems/organs involved
  • 37. Clinical manifestation The symptoms are so broad , non-specific , and acute deterioration , How to make a diagnosis as early as possible ?
  • 38.
  • 39.
  • 40. Reference values for neutrophilic cells Manroe BL, J Pediatr 1979;95:89-98.
  • 41. Total neutrophils Immature neutrophil I/T ratio
  • 42.  
  • 43.
  • 44. Lab Exam: Organism detection  blood culture  culture of body fluid and secretion  plasma brown layer smear --Detection of antigen: usually for antibody of GBS or E coli in CSF, blood and urine --Molecular biochemical method PCR
  • 45. Summary Is there a diagnostic marker for neonatal sepsis?
  • 46.
  • 47.
  • 48.
  • 49.
  • 50. Treatment  Antibiotics therapy  management of complications  supporting therapy  Clearance of infectious focus  Immunotherapy
  • 51.
  • 52. Dosages of antibiotics for newborns
  • 53.
  • 54.
  • 55.
  • 56.