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23 Cards in this Set
- Front
- Back
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What is the difference of incidence between early and late onset of neonatal sepsis?
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Early 1-4/1,000
Late 1 - 2/1,000 Early onset numbers have decreased due to GBS screening. |
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T or F intrapartum complications are present in history with patients who aquire late-onset neonatal sepsis.
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False. Late - onset history is negative for intrapartium complactions - they are however, present in early onset.
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What is the difference in clinical manifestions for neonatal sepsis - early vs late?
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early - pneumonia/multisystem/filminant
late - meningitis/focal/insidious |
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What is the mortality rate of neonatal sepsis - early vs late
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Early - 5% term
20% preterm |
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What are the most common pathagons for early onset sepsis on the east coast? West coast? Europe?
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East = GBS +
West = Gram negative enteric bacteria Europe = Coagulase-negative staphylocci |
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What is a synonoum for GBS +
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group B streptococci
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T or F
Birth weight affects sepsis coloniization |
Ture - the less the weight the more likely they are to to become septic
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How do you define chorioamnionitis?
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according to Gibbs: Elevated maternal and fetal heart rate, maternial leukocytosis, urterine tenderness
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When can you be assured that the GBS status is accurate?
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When the culture is closer to the time of delivery
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What type of antibodies are can cross the placenta, and when does this crossing occur?
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28-30 weeks IgG
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When do clinicans opt to treat/or aim to prevent GBS?
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In the intrapartum phase of a pregancy
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What are the two strategies for prevetntion of GBS as recomended in 1996 by the CBC?
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Late term cultures and then treat or treat based on intrapartum risk factors where you just give antibiotics to women with risk factors, and antibodics should be given to all woemn who have GBS + sibliings, or with invasive dieseases - maternal bacteriuria
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What is the likelyhood that the neonatal GBS status will match maternial status when the infant is 35-37 weeks old
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90% that the GBS status will match
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Is there a racial disparities in early onset GBS disease?
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Yes- blacks are more llikely to get GBS 2.5
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Has the decreased rates of early onset GBS affected gram negative disease?
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No there has not become a superbug, nor has there been a increase of GBS+ late onset
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Has there been ampicillin susceptibility of E.coli Isolates in preterm infants?
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Yes the rate of ampicilin susceptibiliiity of E.coli isolates in preterm infants has increased
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What have the changes in pathogens for sepsis been im the VLBW infants
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gram negative e. coli
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What is the rate of meningitis among VLBW infants?
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High - 1/3 of all pts who have meningitis do not have positive blood cultures
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What is the likelyhood of a ELBW infants to have neurodevelomental impairment
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65% have someform of neuro delay
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What is an I/T ratio?
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immature white blood cells over total white blood cells
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What are the markers of Neonatal Sepsis?
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CBC - WBC, I/T ratio,(neutropenia)
Cytokines (TNF, IL-6, IL-8) Acute phase proteins(CRP, procalcitonin) |
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What is the management of Asymptomatic Newborns, following maternal intrapartum prophylaxis?
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Term infants >35, no evaluation, CBC &CRP at 12 and 24 hours, observation
Preterm infant - CBC, CRP at 12 and 24 hours, blood culture, empiric thearpy |
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How long for a child to have thereputic effects of ampicillin before delivery
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4 hours of antibiotic exposure
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