CARE OF NEONATES WITH NEONATAL SEPSIS.PPT

CARE OF BABY WITH NEONATAL SEPSIS

2. NEONATAL
SEPSIS
Mrs. MALARAATHI MSN
LECTURER

3. INTRODUCTION
Neonatal sepsis is a serious problem
causing high mortality in neonates. Early
recognition & treatment of the condition
can reduce the fetal outcome.

4. Alternative Names
•Sepsis neonatorum;
•Neonatal septicemia

5. Definition
Neonatal sepsis is defined as a clinical syndrome of
bacteremia with systemic signs and symptoms of
infection in the first 4 weeks of life.
When pathogenic bacteria gain access into
the blood stream, they may cause overwhelming
infection without much localization (septicemia) or
may get predominantly localized to the lung
(pneumonia) or the meninges (meningitis).

6. Facts about NS
Common
20% of VLBW has sepsis
In term 0.1%
Inter-institution difference 11-32%
(NICHD net work)
Serious
Mortality is 3-5 times more for infant
with sepsis in NICU

7. Classification
Early onset sepsis (EOS):
•It develops before 72 hrs of life due to due to
intrauterine infections, maternal condition &
intranatal causes.
•5-7/1000 live birth
•It manifests frequently as pneumonia, septicemia,
& meningitis.
Late onset sepsis (LOS):
•It develops after 72 hrs due to nosocomial
infection & inappropriate neonatal care.

8. Source of infection
•Infusion sets
•Iv sites
•Face mask
•Feeding bottles.
•Catheters.
•Ventilators
•Incubators
•Baby care articles.
•Unhygienic envt
•Infected care givers.

9. Causative agents
Escherichia coli
Staphylococcus aureus.
Klebsiella pneumoniae

10. Pre-disposing factors
•Intrauterine infections
•Premature & prolonged
rupture of membrane.
•Meconium stained liquor
•Repeated vaginal exam
•Maternal infections
•Lack of aseptic practices
•birth asphyxia
•LBW
•Invasive procedure

11. Clinical symptoms
Tachypnea
Lethargic
Feeding difficulties
Difficulty Breathing Temp Instability
Jaundice
Irritability
Abdominal Distention

12. Clinical symptoms
Diarrhea
Vomiting
Evidence of pneumonia
Evidence of meningitis

13. Diagnosis
Blood culture
Swab culture from septic
umbilicus.
Lumbar Puncture
Urine routine, culture.
Chest x-ray
Bldsugar
Serumbilirubin
Leukocyte count
ESR
C-reactive protein

14. Management
•Supportive Care
•Antibiotic therapy

15. Supportive Care
oMaintenance Of Warmth
oAdminster Iv Fluid-10ml/Kg
oOxygen Therapy
oBag & Mask Ventilation
oVit K Injection 1mgim
oGentle Physical Stimulation
oClose & Constant Monitoring Of
Newborn.
oExpert Nsgcare.

16. Antibiotic therapy
•Consider causative organism.
•Duration of antibiotic therapy should be
individualized.
•In general antibiotics should be given 10-14
days.
•Antibiotics used are
•Ampicillin
•Gentamycin
•amikacin
•Amoxicillin
•Cloxacilin

17. •Other drug therapy includes anti
Convulsive ( Diazepam,
Phenobarbitone)
•Phototherapy In Hyperbilirubinemia
•Treatment For Superficial Infections
Like Umbilical sepsis, pyoderma, oral
thrush, conjunctivitis.

18. Prognosis
•25-30% die in case of neonatal sepsis.
•Extremely high mortality is associated
with endotoxic shock, sclerema, NEC,
DIC etc. Associated congenital
malformations like meningomyelocele,
TEF, LBW and surgical procedure.
•Early initiation of specific antimicrobial
therapy will improve the outcome
•

19. Prevention
•Strict aseptic mgt of institutional delivery.
•Prevention & treatment of maternal infection.
•Hand washing before handling of the babies.
•Clean home delivery.
•Minimum handling of baby.
•Exclusion of infected person from neonatal
areas.
•Maintenance of cleanliness of baby & mother.
•Strict aseptic technique for invasive procedure.

20. •Avoid unnecessary iv fluids. Needle
prick.
•Encourage EBF
•Early detection & starting of antibiotic
therapy.