Neonatal Sepsis in peads and its treatment management.pptx

*Neonatal Sepsis: A Comprehensive Overview*

Neonatal sepsis is a life-threatening condition that occurs when bacteria or other pathogens enter the bloodstream of newborns, triggering a systemic inflammatory response. This serious infection can progress rapidly, causing organ dysfunction, respiratory distress, cardiovascular instability, and even death.


*Definition and Types:*

1. Early-onset neonatal sepsis (EONS): Occurs within 72 hours of birth, often related to maternal factors.
2. Late-onset neonatal sepsis (LONS): Develops after 72 hours, frequently linked to hospital-acquired infections.


*Causes and Risk Factors:*

1. Maternal factors:
- Chorioamnionitis
- Group B streptococcal colonization
- Urinary tract infections
2. Neonatal factors:
- Premature birth
- Low birth weight
- Respiratory distress
- Umbilical catheterization
3. Hospital-acquired infections:
- Healthcare-associated bacteria
- Contaminated medical devices


*Symptoms:*

1. Temperature instability
2. Respiratory distress
3. Bradycardia or tachycardia
4. Hypotension
5. Lethargy or irritability
6. Poor feeding
7. Vomiting
8. Abdominal distension


*Diagnosis:*

1. Blood cultures
2. Complete blood count (CBC)
3. C-reactive protein (CRP) test
4. Procalcitonin (PCT) test
5. Lumbar puncture (LP)
6. Imaging studies (e.g., chest X-ray, ultrasound)


*Treatment and Management:*

1. Antibiotic therapy
2. Fluid management
3. Oxygen therapy
4. Respiratory support (mechanical ventilation)
5. Cardiovascular support

1. Neonatal Sepsis It IS A CLINICAL SYNDROME OF SYSTEMIC ILLNESS RESULTING FROM METABOLIC AND CIRCULATORY COLLAPSE FROM INFECTION IN THE NEWBORN.

2. Early onset Sepsis presents within first 3 days of life. Late onset Sepsis presents between 4 days upto 1 month of age. Predisposing factors for Sepsis: HOST Factors (in the newborn); due to impaired cellular and humoral response and low serum complement levels. Maternal factors: poor socioeconomic status, prolonged labor, maternal illness at the time of labor and delivery Environmental factors: home delivery, bacterial contamination, prematurity(single most significant correlated with sepsis)

3. Etiology E. coli GBS Klebsiella Pseudomonas Staphylococcus Proteus

4. Clinical Findings Refusal to feed Ill looking Poor temperature control Poor peripheral perfusion Tachycardia or bradycardia Lethargic Irritability Respiratory distress Vomiting, diarrhea

5. Investigations WBC Count: It is the most reliable indicator. Elevataed (>30000) or low (<4000) WBC count is significant. High ESR and CRP CXR Blood culture CSF culture Urine culture Tracheal Aspirate culture

6. Management EARLY ONSET SEPSIS : Ampicillin + Aminogylcoside or cefotaxime are given Ampiciilin (100-300 mg/kg/day IV in 8 hourly doses Gentamicin(5mg/kg/day IV in 8-12 hourly doses Cefotaxime (100mg/kg/day IV in 8-12 hourly doses LATE ONSET SEPSIS: Vancomycin + Aminogylcoside are given Vancomycin (15mg/kg/dose given 8 hourly Amikacin (15mg/kg/day in 12 hourly doses.

7. Supportive treatement Good temperature control Monitor vital signs Intake output record Fluid and electrolyte balance Respiratory support Monitor and manage metabolic disturbances Seizures should be treated with anticonvulsants TPN if infant cant tolerate enteral feeding

8. Complications of Sepsis Endocarditis Septic emboli Osteomylitis Septic shock DIC Organ failure Abscess formation

9. Prevention Maternal vaccination against rubella, VZV, Hepatitis B, Tetanus Aggressive management of suspected maternal chorioamnionitis with antibiotic therapy. Breastfeeding and handwashing are helpful in prevention of late onset sepsis