Neonatal sepsis is an important topic in Pediatrics for the NEET PG Exam because it is a serious and potentially life-threatening condition that requires early recognition and appropriate management. It is a significant cause of morbidity and mortality in the neonatal period, especially in premature or low-birth-weight infants.
In this blog we’ll cover the associated risk factors, clinical features, diagnosis and treatment of neonatal sepsis. Keep reading.
Definition
A clinical syndrome characterized by signs and symptoms suggestive of systemic neonatal infection with or without bacteremia.
Classification
Early onset sepsis (EOS)
Late onset sepsis (LOS)
Early onset sepsis
Onset usually within within 1st 72 hrs. of life
Organisms responsible are usually derived from maternal genital tract like Group B streptococci, E.Coli.
Risk factors
Mother:
Foul smelling liquor
Premature rupture of membranes (≥ 24 hours prior to delivery)
Delivery:
Difficult/ prolonged labour (1st and 2nd stage duration > 24 hours)
Lumbar puncture & CSF study (in all cases of LOS and cases of EOS with neurological features)
Treatment:
Supportive Care
Shift to Nursery/ NICU
Start IV fluids
Maintain normal temperature (36.5- 37.5 degrees)
Maintain euglycemia
Maintain normal oxygen saturation
Specific Treatment
I.V. broad Spectrum Empirical antibiotics
Indications
EOS
Foul smelling liquor
≥ 3 risk factors for EOS
<3 risk factors +clinical features suggestive of neonatal sepsis and +ve sepsis screen
Strong clinical suspicion of EOS
LOS
+ve sepsis screen
Strong clinical suspicion
Which antibiotics?
Inj. Ampicillin + inj. Gentamicin + Inj. Cefotaxime (3rd generation cephalosporin), if meningitis present or suspected
Duration of antibiotic therapy
Sepsis screen
Blood culture
CSF S/O meningitis
Duration of Antibiotics
-
-
-
3 days
+
-
-
1 week (7-10 days)
±+/-
++/-
-+
2 weeks 3 weeks
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