Teaching Aids: NNFNS-1 Neonatal sepsis Clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first four weeks of life.

Slides:



Advertisements
Similar presentations
Fever in paediatrics Dr Ehsan Ahmed (Consultant Paediatrician
Advertisements

Chapter 6 Fever Case I.
Chapter 5 Diarrhoea Case I
2007. Detection of fever  Children aged 4 weeks to 5 years  Measure temperature by  Electronic thermometer in axilla  Chemical dot thermometer in.
Chapter3 Problems of the neonate and young infant - Neonatal resuscitation.
SEPSIS KILLS program Adult Inpatients
Neonatology: Neonatal Septicemia. Lecture points Morbidity and mortality The compromised host of the neonates in immunology Pathogens for clinical consideration.
Danger Signs in Newborn
Doug Simkiss Associate Professor of Child Health Warwick Medical School Management of sick neonates.
Resident Lecture Series: Sepsis Nneka I. Nzegwu, DO Neonatal-Perinatal Clinical Fellow Yale-New Haven Children’s Hospital.
Chapter 5 Diarrhoea Case II
Recognition and management of the seriously ill child Dr Esyld Watson Consultant in Adult and Paediatric Emergency Medicine.
BY: DRA.Fatma .s.al zahrani
By Dr. Gacheri Mutua.  Is a blood infection that occurs in an infant younger than 90 days old.  Occurs in 1 to 8 per 1000 live births highest incidence.
Assessment of Febrile child Ravi Seyan. F2F encounter Consider ABC A- airways B- Breathing C- Circulation.
Joanne Ang Pediatrics Rotation – Nursery.  Infection – important cause of neonatal and infant morbidity and mortality  2% of fetuses are infected in.
Outline Definition of isolation Principles of Isolation Isolation Policy Policy implementation Personnel Roles & Responsibilities Visitation.
Neonatal Sepsis NICU Night Team Curriculum. Sepsis: Objectives Define Sepsis Review common pathogens causing sepsis in a neonate Review clinical findings.
Neonatal Sepsis Kirsten E. Crowley, MD June, 2005.
Neonatal Sepsis and Recent Challenges Mohammad Khasswneh, MD Assistant Professor of Pediatrics JUST.
1 EssentialPostpartum and andNewborn Care Care MCH in Developing Countries January 24, 2008.
1 Neonatal Sepsis By Dr. Nahed Said Al- Nagger. 2 Objectives: Define neonatal sepsis. 1. List the causes make neonates susceptible to infection. 2. State.
To treat or not to treat? Infants born with maternal chorioamnionitis Mary Angela Woodward,MD April 29,2015.
Nov 2007 ACoRN © Infection Sequence. Nov 2007ACoRN ©
Chapter 3 Problems of the neonate Low birth weight babies
Chapter 3 Problems of the neonate Low birth weight babies.
Chapter 3 Problems of the neonate and young infant Infection
The Sick Infant: Five Deadly Misconceptions Todd Wylie, MD University of Florida Department of Emergency Medicine June , 2009.
Doug Simkiss Associate Professor of Child Health Warwick Medical School Serious maternal and neonatal infections in the local context.
Special care of preterm babies
Neonatal Sepsis Islamic University Nursing College.
Paediatric Microbiology Dr Amy Chue ID/Microbiology Registrar Dr Peter Munthali Consultant Microbiologist.
Controversies in managing neonatal infections David Isaacs Children’s Hospital at Westmead Sydney Australia.
Response to foreign body Inflammatory reaction –Localized –Generalized Generalized inflammatory reaction –Infective –Noninfective Sepsis: Generalized inflammatory,
Neonatal Sepsis Maria Angelica M. Geronimo. Epidemiology Newborn Health in the Philippines: A Situation Analysis June 2004.
Chapter 3 Clinical signs of serious neonatal illness.
Morning Report August 9, 2010.
At the start of a sick child (2 months to 5 years) consultation
Failure to Thrive in the First Month of Life Family Medicine Specialist CME Pakse, Laos PDR, October 15-17, 2012.
Infection International Infection. International Objectives definition predisposing factors pathophysiology clinical features sites of postpartum infection.
NEONATAL SEPSIS. Neonatal sepsis can be either: Early neonatal sepsis: -Acquired transplacentally -Ascending from the the vagina, -During birth (intrapartum.
Umblicus Content of cord: two umblical arteries one umblical vein wharton jelly Sheath derived from amnoin.
Neonatal Infections Dr. Mohamed Haseen Basha Assistant professor (Pediatrics) Faculty of Medicine Al Maarefa College of Science and Technology.
INTRODUCTION TO INFECTION CONTROL ICNO Infection Control Unit, Teaching Hospital, Jaffna.
Newborn infant By : Dr.Sanjeev. Thermal protection in newborn Due to reduced subcutaneous and brown fat Brown fat : - Site : adrenal glands, kidneys,
NEONATAL SEPSIS Ekawaty Lutfia Haksari Perinatology, Department of Child Health Gadjah Mada University.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The Normal Newborn Chapter 12.
1Dr vakili amini. History Prenatal :maternal,fetus Perinatal and birth time postnatal 2.
NEONATAL SEPSIS Dr.Sayid.,MD. Dept.Paediatrics Dept.of Paediatrics.
PNEUMONIA BY: NICOLE STEVENS.
NEONATAL SEPSIS. Neonatal infections are estimated to cause about 1.6 million deaths worldwide and 40% of all neonatal deaths due to sepsis occur in developing.
RESPIRATORY DISTRESS SYNDROME IN NEONATES
Chapter 6 Fever Case I.
GBS Prophylaxis indicated for mother? Adequate treatment?
Chapter 3 Problems of the neonate and young infant Infection
Febrile Infant.
CASE 4 Dr Sani Aliyu Consultant in Microbiology & Infectious Diseases Cambridge University Hospitals.
Neonatal Sepsis.
PCP: Clinical Presentation
Chapter 3 Clinical signs of serious neonatal illness
Neonatal sepsis in Kilifi
Chapter 3 Clinical signs of serious neonatal illness
PCP: Clinical Presentation
Chapter 5 Diarrhoea Case I
Chapter 6 Fever Case I.
High-Risk related to Infectious Processes
Chapter 3 Problems of the neonate and young infant Infection
Empiric antibiotic therapy
Presentation transcript:

Teaching Aids: NNFNS-1 Neonatal sepsis Clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first four weeks of life

Teaching Aids: NNFNS-2 Neonatal sepsis COMMONEST CAUSE OF NEONATAL DEATHS Source: Bang AT et al, Lancet 1999

Teaching Aids: NNFNS-3 Common organisms Klebsiella pneumoniae Escherichia coli Staphylococcus aureus Pseudomonas

Teaching Aids: NNFNS-4 Early vs Late onset sepsis EarlyLate Onset Upto 72 hrsAfter 72 hrs Source MaternalPostnatal environment Presentation Fulminant multisystem Pneumonia frequent Slowly progressive,focal Meningitis frequent Mortality15-50%10-20%

Teaching Aids: NNFNS-5 Symptoms of neonatal sepsis  CNS  Lethargy, refusal to suckle, limp, not arousable, poor or high pitched cry, irritable, seizures  CVS  Pallor, cyanosis, cold clammy skin  Respiratory  Tachypnea, apnea, grunt, retractions

Teaching Aids: NNFNS-6 Symptoms of neonatal sepsis  GIT  Vomiting, diarrhea, abdominal distension  Hematological  Bleeding, jaundice  Skin  Rashes, purpura, pustules

Teaching Aids: NNFNS-7 Signs of neonatal sepsis  Cold to touch ( hypothermia )  Poor perfusion ( CRT )  Hypotension  Renal failure  Sclerema  Bulging fontanels, neck retraction  Poor weight gain* *Indicates low grade sepsis

Teaching Aids: NNFNS-8 Clinical features of severe infections WHO Young Infant study Feeding ability reduced 2. No spontaneous movement 3. Temperature >38 0 C 4. Prolonged capillary refill time 5. Lower chest wall indrawing 6. Resp. rate > 60/minute 7. Grunting 8. Cyanosis 9. H/o of convulsions

Teaching Aids: NNFNS-9 Diagnosis of neonatal sepsis Direct - Isolation of organisms from blood, CSF, urine is diagnostic Indirect -Screening tests

Teaching Aids: NNFNS-10 Sepsis screen Leukopenia (TLC < 5000mm 3 ) Neutropenia (ANC < 1800/mm 3 ) Immature neutrophil to total neutrophil (I/T) ratio (> 0.2) Micro-ESR (> 15mm 1 st hour) CRP +ve * If two or more tests are positive treat infant as neonatal sepsis

Teaching Aids: NNFNS-11 Mature neutrophilBand cell Neutrophils

Teaching Aids: NNFNS-12 Meningitis percent cases of sepsis have meningitis Meningitis can be often missed clinically LP must be done in all cases of late onset & symptomatic early onset sepsis

Teaching Aids: NNFNS-13 Management: Supportive care Keep the neonate warm If sick, avoid enteral feed Start IV fluids, infuse 10% dextrose- 2 ml/kg over 2-3 minutes to maintain normoglycemia Maintain fluid and electrolyte balance and tissue perfusion. If CRT >3 sec, infuse 10 ml/kg normal saline

Teaching Aids: NNFNS-14 Supportive care  Start oxygen by hood, if cyanosed or having RR >60/min or severe chest retractions  Consider exchange blood transfusion, if there is sclerema

Teaching Aids: NNFNS-15 Choice of antibiotics  Pneumonia or Sepsis Penicillin Aminoglycoside (Ampicillin or Cloxacillin) (Gentamicin or Amikacin)  Meningitis Ampicillin + Gentamicin Or Gentamicin or Amikacin + Cefotaxime +

Teaching Aids: NNFNS-16 Suspected neonatal sepsis Start parenteral antibiotics Send cultures (report in 72 hrs) Culture -veCulture +ve Clinically not sepsis (Stop Ab) Clinically ill (Cont Abx7-10D) Pneumonia, Sepsis (Cont Ab X 7-10D) Meningitis, Osteomyelitis (Cont Ab X 3-6 wks)

Teaching Aids: NNFNS-17 Superficial infections Pustules -After puncturing, clean with betadine and apply local antimicrobial Conjunctivitis -Chloramphenicol eye drops Oral thrush -Local application of nystatin or Clotrimazole

Teaching Aids: NNFNS-18 Prevention of infections Exclusive breastfeeding Keep cord dry Hand washing by care givers Hygiene of baby No unnecessary interventions

Teaching Aids: NNFNS-19 A scanned picture of steps of hand washing Six steps of hand washing Step 1 Wash palms with fingers Step 2 Wash back of hands Step 3 Wash fingers & knuckles Step 5 Wash finger tips Step 6 Wash wrists Step 4 Wash thumbs

Teaching Aids: NNFNS-20 Hand washing Simplest, most effective measure for preventing hospital acquired infections 2 minutes hand washing prior to entering nursery 15 seconds of hand washing before touching baby Alcohol based hand rub effective but costly

Teaching Aids: NNFNS-21 Control of hospital infections Hand washing by all staff Isolation of infectious patient Use plenty of disposable items Avoid overcrowding Aseptic work culture Infection surveillance

Teaching Aids: NNFNS-22 Work culture Sterile gowns and linen for babies Hand washing by all Regular cleaning of unit No sharing of baby belongings Dispose waste-products in separate bins

Teaching Aids: NNFNS-23 Control of hospital outbreak of infections Epidemiological investigation Increased emphasis on hand washing Reinforce all preventive measures Review of protocols of nursery Screen all personnel Review of antibiotic policy Cohorting of infants

Teaching Aids: NNFNS-24 Fumigation Use Potassium permanganate 70 gm with 170 ml of 40% formalin for 1000 cubic feet area for 8-24 hours alternatively Bacillocid spray for 1-2 hours may be equally effective

Teaching Aids: NNFNS-25 Conclusion High index of clinical suspicion Look for lab evidence of sepsis Start parenteral antibiotics (I.V.) Ampicillin + Aminoglycoside Provide supportive care Review culture reports Practice barrier nursing to prevent cross-infection