Maternal Leukocytosis ( White Blood Cell count >15000)
Rupture of Membranes > 12 hours
Tachypnea (<1 hour)
Maternal Group B Streptococcus Colonization
Low APGAR (<5 at 1 minute)
Low birth weight (<1500 grams)
What makes a neonate’s immune system susceptible to sepsis? Maturity Immaturity or
You’re Right!!!! The immaturity of a neonate’s immune system makes them MORE SUSCEPTIBLE to sepsis.
Why are newborns so vulnerable to infection? Non-specific immunity Specific immunity
Why are newborns so vulnerable to infection? IMMUNE SYSTEM Neutrophils – Qualitative and quantitative Complement and immunoglobulin levels decreased T cells- antigenically naïve limited cytokine production
1.5% of VLBW infants had EOS (intrapartum antibiotics)
Late onset sepsis (LOS):
bacteria acquired after delivery (Nosocomial or community)
20% of VLBW infants
Clinical menifestations EOS LOS Onset Within 7 days >7 days Source Prenatal During delivery During delivery Postnatal(nosocomial ) Pathogens G - bacili S taphylococcus ; Opportunitic P resentation Mortality P neumonia High Bacteremia and / or meningitis Low
Symptoms of Neonatal Sepsis The symptoms are not concrete and vary widely Tachypnea Heart Rate Changes Feeding difficulties Difficulty Breathing Temperature Instability J aundice Irritability
Clinical presentation Early warning signs are often non-specific and subtle easily confused with non-infective causes (e.g. apnea of prematurity, variation in environmental temperature or acute exacerbation of chronic lung disease) clinical course alarmingly fulminant septic shock + DIC death Non-specific, multi- systems/organs involved
Clinical manifestation The symptoms are so broad , non-specific , and acute deterioration , How to make a diagnosis as early as possible ?
Lab Exam: Organism detection blood culture culture of body fluid and secretion plasma brown layer smear --Detection of antigen: usually for antibody of GBS or E coli in CSF, blood and urine --Molecular biochemical method PCR
Summary Is there a diagnostic marker for neonatal sepsis?