Neonatal

Infections
Subtitle

Transmission of Infection of Neonate

Transmission of Infection of Neonate

Before

In utero

Rubella, CMV, Syphilis, HIV, Toxoplasmosis

During

Passing of the baby through birth canal

After

Contracted after birth from hospital (nosocomial)

Hospital staff and equipment: germs

Preventative

Eye drops to prevent syphilis and gonorrhea

Hepatitis vaccine

Sepsis Neonatorum

Systemic infection from bacteria

Common agent

Group Beta strep (GBS)

most common, before and during

can be misdiagnosed, same S&S as respiratory distress syndrome

Staph

easily spread

Influenza

Listeria

E. Coli

Candida (oral yeast infection)

thrush in babys mouth

Diagnostics

Diagnostics

CBC with diff

elevated WBC (but it is normally elevated in infants)

increase neutrophils (left shift)

increase in bands

Elevated immunoglobulin M

after birth, if this is elevated, the baby has an infection

C-reactive protein rises

Inflammatory process

SIRS

Blood cultures

culture FIRST: nose, urine, CSF

determine what antibiotics to give

Manifestations

General

temp may be low

presence of rash

Respiratory

Respiratory distress -3 big symptoms: nasal flaring, grunting and retractions,

tachypnea

CV

Discoloration of the skin, blue or pale

tachycardia,

hypotension

Manifestations

GI

Dont feed well

Low? Gastric residual due to not tolerating the food

Neurologic

High pitched crying

Irritable

Muscle tone flabby

Fontanel full

Advanced infection

Liver involvement: increased bilirubin, jaundice, splenomegaly, hepatomegaly

Septic shock

Anemia

Interventions

Interventions

Prevention: Hand washing - the best prevention!!!

Disinfect equipment

Maintain sterility for invasive procedures

Antibiotics: culture and sensitivity

Supportive: Support the family

Infections effect on Newborn

Varicella-Zoster

It is safe for the mother to get Varicella-Zoster vaccination during pregnancy, mom will develop
antibodies and they will be passed to the baby. But she needs time to develop antibodies. So, if
she will receive vaccine right before the birth of the baby, she will not have time to develop
antibodies and the baby will get sick. But if she received vaccine earlier at 13-20 week she will
have time to develop antibodies and they will be passed to the baby, the baby will not get sick.

If mother contracts chicken pox between 13-20 weeks, child can have congenital problems

Small head

Scars

IUGR(intrauterine growth restriction)

Cataracts

Varicella Zoster Immunoglobulin Vaccine

mother and child will need to be isolated

Infections effect on Newborn

Group B strep

Colonizes in the vagina, rectum

Baby gets symptoms after the first week of birth

3 main things baby can get from GBS

Meningitis, pneumonia, full - blown sepsis

Meningitis- most common

Drug of choice is Penicillin, if for some reason baby cant take it the
other drug will be Ampicillin

Infections effect on Newborn

Gonorrhea

Can cause blindness

Give prophylactic eye drops

Infections effect on Newborn

TORCH

(TOxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex)

Can have it all at once or separate

Toxoplasmosis

not very common in the US, very common in Europe

undercooked meats

poor sanitation

cats (if pregnant dont touch a litter box)

feed cat of raw food, dont let him eat raw meat or go outside to catch lizards, mice...

Rubella:

causes spontaneous abortion

Cardiac defects

Deafness

Cataracts

Virus can shed for months

PREVENTION: Rubella vaccination (MMR in a younger age) for mother

No treatment

Infections effect on Newborn

Cytomegalovirus:

Opportunistic virus

Affects people with decreased immune system

High incidence in daycare centers

Usually not harmful, unless immunocompromised, it is very common

Transmitted through kissing, sex

No treatment

Acyclovir: decrease the severity and length of time, doesnt cure

Any antiviral meds

Infections effect on Newborn

Herpes simplex:

Genital herpes

If mother has active genital herpes, she will have a C-section

Otherwise mother can have a vaginal birth

No cure-virus

Treatment:

acyclovir: decreases severity and length of time

Antibiotics

Viruses: herpes, rubella and cytomegalovirus has no cure because

they are viruses

Treatment

Treatment

Broad spectrum antibiotics

Culture first, then give broad spectrum until bacteria, protozoa, or fungi is determined

may give triple antibiotic

Oxygen

Fluid balance

hypotension: may give some volume

Urine output hourly

hypovolemic

BP

Respiratory distress

especially when dealing with BP and fluid balance

Monitor for

Shock

Hypoglycemia

Electrolyte imbalance

Temperature regulation: usually low in babies

Isolate if needed

Handwashing

Treatment

Broad spectrum antibiotics

Oxygen

Fluid balance

BP

urine output hourly

Monitor for

Shock

Hypoglycemia

Electrolyte imbalance

Temperature regulation