NICU Educators
Early onset neonatal infections Within the first 72 hours of life Manifest – pneumonia and/or septicaemia Incidence = in gender High mortality 10-30% Usually acquired from the birth canal eg Group B Strep (80%) Risk factors Prolonged membranes Preterm Maternal pyrexia UTI, gastro
Late onset sepsis (after 72 hours) Organisms acquired around the time of birth or in hospital eg neg staphylococcus Male predominance <1000 grams are particularly at risk Mortality rate >5% >70% - Coagulase negative Staphyloccus & Staphylococcus aureus 10-15% gram negatives Candida particularly in ELBW Long term impairment
BPD, proven sepsis, ROP, brain injury
N=192 < 30wk
24-27wk babies, n=541 Multicentre swiss cheese Schlapback Ped 2011
Features of late onset sepsis Cross infection by staff and parents Prolonged hospitalisations eg preterm Presence of foreign bodies eg. IV, ET, PICC Malformations such as neural tube defects
How infection is transferred HANDS! Health Care Workers Rotating personnel Persistent carriers Acute infections staff/visitors Frequent handling Hand Hygiene : 80% of transmission of hospital infection is by contaminated hands!
June 2015 hand hygiene
NICU hand hygiene June 2015
How do you stop contamination?
Entering the patients space
Step 2 roll up the cover
Step 3 open door
Step 4 gel
Step 5 touch baby
Step 6 - Gel
Gel, Baby, Gel I am worth it!