This document discusses various neonatal infections, including neonatal sepsis, opthalmia neonatrum, congenital syphilis, Group B streptococcus, Escherichia coli, Listeria monocytogenes, neonatal meningitis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, hepatitis virus, chlamydia, candida albicans, and the importance of teamwork in managing these conditions. It provides information on the causative organisms, pathophysiology, signs of infection, and treatment recommendations for each condition.

1. NEONATAL INFECTIONS, NOENATAL SEPSIS, OPTHALMIA NEONATRUM & CONGENITAL SYPHILLIS
Dr. JayeshPatidar
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2. Anti microbial selection
1.E.Coli,Klebsiella,Shigella&Salmonella: Amnioglycoridesor3’rdgenerationCehalosponis.
2.HaemophilusInfluenza:Ampicillin&3’rdgenerationCehalosponis.Sometimesampicillinareresistant.
3.Pseudomonas:Amnioglycorides+antipseudomonaspencillin.
4.BacteroidesFragilis:Metronidazole,clindamycin, somebetalactomosessuchasimipenum&ampicillinwithsulbactim&chloramphenicol.
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3. Group B Streptococcus
Groupbstreptococcushemolyticstreptococciwereunknowntotheperinatalsceneuntilthereearly1970’swheretheyreplacedE.Coliasthesinglemostcommonagentassociatedwithbacterialmeningitisduringthe1’st2monthsoflife.
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4. Pathophysiology
Intensityofthematernalcolonizationisdirectly
Relatedtoriskofinvasivediseaseintheneonatebecauseoflow&highdensitycolonization
RiskofamnioticfluidcontaminatedwithmeconiumorvernixcaseosawhichpromotesthegrowthoftheGBS&E.Coli
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5. Conts….
FeworganismsinthevaginalvaultduetothePMOM
Possiblycontributingtotheparadox.
Organismsusuallyreachthebloodstreambyfetalaspirationorswallowingofthecontaminatedamnioticfluid
Leadingtobacteremia.
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6. Escherichia Coli
E.Coliisagramnegative,nonsporeformingmotilerod.Itisanormalinhabitantofthegastrointestinaltract&mostcommoncauseofthegramnegativeinfectioninthenewborn.
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7. Listeria Monocytogenes
1.Itisfoundinthebirds&mammals,includingdomesticandfarmanimals.
2.Itisfoundintheunpasteurizedmilk,soilandfecalmatter.
3.Theinfectionappearstobeundiagnosedandanunderreportedcauseofthecongenitalinfection.
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8. Neonatal meningitis
Aneonatalbacterialmeningitisistheinflammationofthemeningesduetothebacterialinvasion.Meningitiscanbeasequenceofthenewborninfection.
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9. Toxoplasmosis
Theimportanceoftheparasitetoxoplasmagondiiwasdiscoveredbyhealthcareworkerthroughtheperinataldeath.
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10. Management
1.Prevention&earlyrecognition.
2.Motheratariskshouldavoidsoildigging,handlingorcookingundercookedmeat.
3.Ifthesignsofinfectionexhibitthenreportimmediately.
4.Congenitaltoxoplasmosis:Pyrimethamine+ Sulfonamides.2mg/kg/day,orallyfor2days, followedby1mg/kg/dayfor2or6months,then1mg/kg/dayeveryMonday,WednesdayandFridayforayearperiod.
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11. Conts…
5.Dosesof100mg/kg/dayisdividedinto2dosesfor1year.
6.Levovorin10mgisgiven3timesweekly&for1weekafterPyrimethaminetherapy.
7.Corticosteroidsaregivenintheformofpredinoseat1mg/kg/dayin2divideddosesuntilthereisaresolutionofelevatedproteininCSF.
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12. RUBELLA
Congenitalrubellaisaviralinfectionacquiredfromthemotherduringpregnancy.Ithasbeenestablishedthattherubellaviruscanberesponsibleforotherabnormalities.
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13. Management
1.Avoid pregnancy for atleast 2 months after immunizations to decrease the risk of rubella syndrome.
2.If the women receives rubella or RHoGAIG (RhIG). The vaccine may not trigger an immune response because blood products & RHoGAIG have pooled sera that may contain antibodies against rubella. Thus the women does not produce antibodies.
3.Trites should be drawn between 6 weeks after the vaccination or at most after 3 weeks.
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14. Conts….
4.Vaccinationisnotrecommendedinpregnancybutincaseiftheydon’twishtocontinuethepregnancytheygoforthevaccination.
5.Avoidcontactswiththepatients.
6.Followupforthechildrenforthecardiacproblems&cataractsshouldbedone.
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15. Cytomegalo virus
Infectionwithcytomegalovirus,amemberoftheherpesfamily,iscommon.CMVisaDNAviruscoveredwithaglycoproteincoatthatcloselyresemblestheherpes&varicellazostervirus.CMVinfectionismoreprevalentinlowereconomicgroup&especiallycommoninthedevelopingcountries.
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16. HERPES SIMPLEX VIRUS
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17. Introduction
Neonatalherpessimplexvirusinfectionisusuallytransmittedduringdelivery.HSVisamemberofafamilyofthelargeDNAvirus. Theycontainlinear,doublestrandsofDNA. TheherpesfamilyalsoincludesCMV, Varicella-Zooster&Epstein-BarrVirus.
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18. Management
1.Antiviraldrug:Acyclavir&Vidarabine.
2.Vidarabine:15-30mg/kg/day/IV,overaperiodof10- 14daysfor12hours.
3.Acyclavir:30mg/kg/day/IVdividedover8hoursfor10to14days.ithelpsindecreasingthereactivationofthevirusparticularlyinthetreatmentofherpessimplexencephalitis.
4.Eye:Trifluridine,1dropevery2hours,aswellasIVtherapy.
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19. Other’s
1.Isolation:viralsheddingprovidesanreservoirforinfectingothers.
2.Familyeducation&support.
3.Handwashingtechniques.
4.Positiveculturesatbirthmayjustreflectcolonization,culturesshouldberepeatedat24to48hours.
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20. Hepatitis virus
ItisadoublestrandedDNAcontainingvirusexposuretoinfectedblood&bodyfluids,percutaneousintroductionofblood&administrationofinfectedbloodproductsaretheprincipalroutesoftransmission.
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21. Chlamydia
ChlamydiatrachomatisinfectionhasbeenidentifiedascausingsignificantincreaseintheincidenceofPROM, thenumberoflowbirthweightbabiesandtherateofinfantmortality.
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22. Candida Albicans
Itisthemoreprevalentformintheneonates.Candidaorganismsareoval, yeastlikecellsthatcanbudtoreproduceC-Albicanproducersendotoxican, hemolysis,pyrogen&protrolyticenzymesthataredamagingtothetissues.
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23. TEAM WORK
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