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Neonatal Sepsis: Dr. Sayali Dhodapkar SSAC, Kalol

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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Sayali Prashant Dhodapkar
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388 views16 pages

Neonatal Sepsis: Dr. Sayali Dhodapkar SSAC, Kalol

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.

Uploaded by

Sayali Prashant Dhodapkar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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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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