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  • Neonatal Sepsis: Dr. Sayali Dhodapkar SSAC, Kalol

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    Sayali Prashant Dhodapkar
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    This document discusses neonatal sepsis. It defines neonatal septicemia as a systemic bacterial infection in a neonate. It describes two main types of sepsis - early onset sepsis (EOS) within 72 hours of birth, usually from maternal genital tract organisms, and late onset sepsis (LOS) after 72 hours, usually from environmental organisms. It lists risk factors and signs to suspect sepsis. Investigations include a sepsis screen of blood tests. Treatment involves supportive care like temperature and feeding management as well as antimicrobial therapy depending on if the infection is septicemia, pneumonia or meningitis and if it is community or hospital acquired.

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    Neonatal septicemia

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    This document discusses neonatal sepsis. It defines neonatal septicemia as a systemic bacterial infection in a neonate. It describes two main types of sepsis - early onset sepsis (EOS) within 72 hours of birth, usually from maternal genital tract organisms, and late onset sepsis (LOS) after 72 hours, usually from environmental organisms. It lists risk factors and signs to suspect sepsis. Investigations include a sepsis screen of blood tests. Treatment involves supportive care like temperature and feeding management as well as antimicrobial therapy depending on if the infection is septicemia, pneumonia or meningitis and if it is community or hospital acquired.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    Download as pptx, pdf, or txt
    147 views16 pages

    Neonatal Sepsis: Dr. Sayali Dhodapkar SSAC, Kalol

    Uploaded by

    Sayali Prashant Dhodapkar
    This document discusses neonatal sepsis. It defines neonatal septicemia as a systemic bacterial infection in a neonate. It describes two main types of sepsis - early onset sepsis (EOS) within 72 hours of birth, usually from maternal genital tract organisms, and late onset sepsis (LOS) after 72 hours, usually from environmental organisms. It lists risk factors and signs to suspect sepsis. Investigations include a sepsis screen of blood tests. Treatment involves supportive care like temperature and feeding management as well as antimicrobial therapy depending on if the infection is septicemia, pneumonia or meningitis and if it is community or hospital acquired.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 16

    Dr.

    Sayali Dhodapkar
    Neonatal Sepsis SSAC,Kalol
    Contents
    • Definition of Sepsis
    • What is sepsis exactly ?
    • Types of Sepsis
    • When to suspect sepsis
    • Investigations
    • Treatment of Neonatal Sepsis
    Definition of Sepsis
    Entry of pathognomic organisms in blood or
    systemic bacterial infection in a neonate is
    generally called as ‘Neonatal septicemia’

    Septicemia

    Pneumonia Meningitis
    Etiology
    • Escherichia coli
    • Staphylococcus aureus
    • Klebsiella sp.
    Types of Sepsis

    ●
    <72 hrs
    Caused by organisms prevalent in
    EOS
    ●

    maternal genital tract


    ●
    Frequently manifests as pneumonia

    ●
    >72 hrs
    ●
    Caused by organisms thriving in the external

    LOS ●
    environment, hands of care providers
    Manifests as septicemia, pneumonia or
    meningitis
    EOS-Predisposing factors
    • LBW
    • Prolonged rupture of membranes
    • Foul smelling liquor
    • Multiple P/V
    • Maternal fever
    • Difficult prolonged labor
    • Aspiration of meconium
    LOS-Predisposing factors
    • LBW
    • Lack of breastfeeding
    • Poor cord care
    • Superficial infections(pyoderma, umbilical
    sepsis)
    • Aspiration of feeds
    • Disruption of skin integrity with needle pricks
    • Use of IV fluids
    When to suspect NS?
    • Needs high index of suspicion
    • Alteration in established feeding behaviour
    • Refusal to suck
    • Lethargic/inactive/unresponsive cry

    • Poor cry
    • Hypothermia
    • Abdominal distension
    • Vommiting
    • Apneic spells
    Pneumonia
    • Fast breathing
    • Chest retractions
    • grunt
    Meningitis
    • Presence of excessive/high pitched cry
    • Fever
    • Seizures
    • Blank look
    • Neck retraction
    • Bulging anterior
    fontanel
    Overwhelming Sepsis
    • Shock
    • Bleeding
    • Sclerema
    • Renal failure
    Investigations-Sepsis screen
    • TLC leukopenia(TLC<5000/cu mm)
    • ANC(Absolute Neutrophil count)-
    ANC< 1800 per cubic mm
    • I/T ratio > 0.2
    • CRP = > 1mg/ dL
    • Micro ESR=
    Treatment
    • Supportive care
    • Antimicrobial therapy
    Supportive care
    • T= 36.5-37.5 degree centigrade
    • O2, proper ventilation
    • Peripheral perfusion-CRT
    • Urine output measurement
    • Optimal nutrition
    • Vit K=1 mg IM
    • Packed cell transfusion
    Antimicrobial therapy
    Clinical situation Srpticemia & pneumonia Meningitis

    1st line •Ampicillin Cefotaxim +gentamicin


    Community acquired OR
    (resistant strains –absent) •Penicillin+ gentamicin

    2nd line •Ampicillin Cefotaxim + Amikacin


    Hospital acquired OR
    (resistant strains-moderately •Cloxacillin +Amikacin
    present)

    3rd line •Cefotaxim + Amikacin Cefotaxim + Amikacin


    Hospital acquired sepsis
    (resistant strains –high
    quantity)
    Questions?

    THANK YOU

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