Presentation on Prevention and Management of Infants With Suspected or Proven Neonatal Sepsis
References:
American Academy of Pediatrics. Prevention and Management of Infants With Suspected or Proven Neonatal Sepsis, 2013.
American Academy of Pediatrics. Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis, 2012.
A Presentation I presented during my neonatology rotation during my internship in NICU out born UITH . Dedicated to all medical interns all over the world. Thanks to my supervising consultants
A Presentation I presented during my neonatology rotation during my internship in NICU out born UITH . Dedicated to all medical interns all over the world. Thanks to my supervising consultants
This presentation focuses on Acute Bacterial Meningitis.
Viral and fungal cause is mentioned but focus is on bacterial meningitis in Pediatrics Patient.
Feel free to correct if there is any error.
Refer to other reference books for clarity.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
Definition of neonatal sepsis,type of neonatal sepsis ,early onset neonatal sepsis,late onset neonatal sepsis,Pathophysiology of neonatal sepsis,,sign and symptoms of neonatal sepsis, diagnosis of neonatal sepsis,management of neonatal sepsis, antibiotic used for neonatal sepsis,prevention of neonatal sepsis, prognosis of neonatal sepsis ,and A summary
This presentation focuses on Acute Bacterial Meningitis.
Viral and fungal cause is mentioned but focus is on bacterial meningitis in Pediatrics Patient.
Feel free to correct if there is any error.
Refer to other reference books for clarity.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
Definition of neonatal sepsis,type of neonatal sepsis ,early onset neonatal sepsis,late onset neonatal sepsis,Pathophysiology of neonatal sepsis,,sign and symptoms of neonatal sepsis, diagnosis of neonatal sepsis,management of neonatal sepsis, antibiotic used for neonatal sepsis,prevention of neonatal sepsis, prognosis of neonatal sepsis ,and A summary
Keith Moore Said "It has been a great pleasure for me to help clarify statements in the Qur'an about human development. It is clear to me that these statements must have come to Muhammad from God, or Allah, because most of this knowledge was not discovered until many centuries later. This proves to me that Muhammad must have been a messenger of God, or Allah."
This presentation reviews some general fever related pearls before segueing into a review of fever workup in neonates, children 3-36 months, and then fever of unknown origin in older children.
Thsi presentation is a sincere attempt to demonstrate the aseptic techniques needed to collect blood culture, urine culture, diagnostic lumbar puncture. Disscussion about the use of there modalities in neonatology practice and the ways to increase their sensitivity and specificity is done.
this presentation is also available in a video lecture format at my Youtube channel - "NeonatoHub". Hope you enjoy it more in that format.
https://www.youtube.com/watch?v=vZ71vymGVC8
Lecture on SexEd for Grade 7 female students
Instead of the usually awkward sex ed lecture, I included self-care in all aspects of health: physical, mental, emotional, social, and spiritual.
List of vaccines available in the market
This list includes trade name, manufacturer, common abbreviation, type and route of administration, and primary and booster doses for pediatric population. It also includes link to the vaccines' product information.
This is helpful especially for starting pediatricians
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. Prevention and Management of
Infants With Suspected or Proven
Neonatal Sepsis
Cristal Ann Laquindanum, MD-MBA
The Medical City
Pediatrics
NICU 2nd year resident
2. Reference:
American Academy of Pediatrics. Prevention and
Management of Infants With Suspected or Proven
Neonatal Sepsis, 2013.
American Academy of Pediatrics. Management of
Neonates With Suspected or Proven Early-Onset Bacterial
Sepsis, 2012.
3. Early-onset sepsis
early-onset sepsis remains one of the most
common causes of neonatal morbidity and
mortality in the pre- term population.
Identification of neonates at risk based on a
constellation of perinatal risk factors that are
neither sensitive nor specific.
diagnostic tests for neonatal sepsis poor
positive predictive accuracy
clinicians often treat well-appearing infants for
extended periods of time, even when bacterial
cultures are negative
4. Risk factors for early-onset neonatal sepsis
Major risk factors:
preterm birth
most closely associated
with early-onset sepsis
maternal colonization with
GBS
rupture of membranes >18
hours
maternal signs or symptoms
of intra-amniotic infection
Other variables:
ethnicity (ie, black
women are at higher risk
of being colonized with
GBS)
low socioeconomic
status
male sex
low Apgar scores
5. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
6. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
7. SIGNS OF NEONATAL SEPSIS?
Full diagnostic evaluation
blood culture
CBC count, including white blood
cell differential and platelet counts
chest radiograph (if respiratory
abnormalities are present)
lumbar puncture (if the patient is
stable enough to tolerate
procedure and sepsis is
suspected)
Signs of neonatal sepsis?
8. SIGNS OF NEONATAL SEPSIS?
Antibiotic therapy
most common causes of neonatal
sepsis, including intravenous
ampicillin for GBS and coverage
for other organisms (including
Escherichia coli and other gram-
negative pathogens) and should
take into account local antibiotic-
resistance patterns
Signs of neonatal sepsis?
9. Antibiotic Therapy
Optimal treatment of infants with suspected early-onset
sepsis is broad-spectrum antimicrobial agents (ampicillin
and an aminoglycoside)
Third-generation cephalosporin (eg, cefotaxime) represent
a reasonable alternative to an aminoglycoside
BUT extensive/prolonged use of third-generation
cephalosporins is a risk factor for invasive candidiasis
Ceftriaxone is contraindicated in neonates because it is
highly protein bound and may displace bilirubin, leading to
a risk of kernicterus.
10. Antibiotic Therapy
Healthy-appearing infants without
evidence of bacterial infection should
receive broad-spectrum antimicrobial
agents for no more than 48 hours
Small preterm infants, some may continue
antibiotics for up to 72 hours while
awaiting bacterial culture results.
11. Antibiotic Therapy
Bacteremia without an identifiable focus of
infection is generally treated for 10 days
Uncomplicated meningitis attributable to GBS is
treated for a minimum of 14 days
Gram-negative meningitis is treated for
minimum of 21 days or 14 days after obtaining
a negative culture, whichever is longer.
12. Antibiotic Therapy
Recent data suggest an association between
prolonged empirical treatment of preterm
infants (>5 days) with broad-spectrum
antibiotics and higher risks of late onset sepsis,
necrotizing enterocolitis, and mortality.
To reduce these risks, antimicrobial therapy
should be discontinued at 48 hours in clinical
situations in which the probability of sepsis is
low.
13. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
14. MATERNAL CHORIOAMNIOTIS?
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
Definition:
Maternal fever of > 38°C (100.4°F) and
at least two of the ff criteria:
maternal leukocytosis
(> 15,000 cells/mm3)
maternal tachycardia
(> 100 beats/minute)
fetal tachycardia
(> 160 beats/minute)
uterine tenderness, and/or
foul odor of the amniotic fluid
15. Risk factors for chorioamniotis
low parity
spontaneous labor
longer length of labor and membrane rupture
multiple digital vaginal examinations (especially
with ruptured membranes)
meconium-stained amniotic fluid
internal fetal or uterine monitoring
presence of genital tract microorganisms (eg,
Mycoplasma hominis)
16. Limited evaluation
blood culture (at birth) AND
CBC count with differential and
platelets (at birth and/or at 6–12
hours after birth)
Antibiotic therapy
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
MATERNAL CHORIOAMNIOTIS?
17. MATERNAL CHORIOAMNIOTIS?
Definition:
Maternal fever of > 38°C (100.4°F) and
at least two of the ff criteria:
maternal leukocytosis
(> 15,000 cells/mm3)
maternal tachycardia
(> 100 beats/minute)
fetal tachycardia
(> 160 beats/minute)
uterine tenderness, and/or
foul odor of the amniotic fluid
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
18. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
19. Is GBS prophylaxis indicated?
Indicated if 1 or more of the following is true:
(1) Mother is GBS-positive late in gestation and is not
undergoing cesarean delivery before labor onset
with intact amniotic membranes
(2) GBS status is unknown and there are 1 or more
intrapartum risk factors:
a. 37 weeks’ gestation
b. rupture of membranes for > 18 hours
c. or temperature of > 100.4°F (38.0°C)
(3) GBS bacteriuria during current pregnancy; or
(4) History of a previous infant with GBS disease.
20. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
21. Is GBS prophylaxis indicated?
Routine clinical care
Watch out for signs of sepsis
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
22. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
23. Did mother receive at least 4 hours intrapartum
penicillin, ampicillin, or cefazolin?
If > 37 weeks’ gestation
Observation at home after 24 hours
if other discharge criteria have been
met
there is ready access to medical care
a person who is able to comply fully
with instructions for home observation
will be present
If any of these conditions is not met
observed in the hospital for at least 48
hours and until discharge criteria have
been achieved.
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
24. Did mother receive at least 4 hours intrapartum
penicillin, ampicillin, or cefazolin?
If signs of sepsis develop
Full diagnostic evaluation
blood culture
CBC count, including white blood
cell differential and platelet counts
chest radiograph (if respiratory
abnormalities are present)
lumbar puncture (if the patient is
stable enough to tolerate
procedure and sepsis is suspected)
Antibiotic therapy
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
25. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
26. > 37 weeks AOG AND
duration of membrane rupture <18 h?
Observe for > 48 hours
If signs of sepsis develop
Full diagnostic evaluation
blood culture
CBC count, including white blood
cell differential and platelet counts
chest radiograph (if respiratory
abnormalities are present)
lumbar puncture (if the patient is
stable enough to tolerate procedure
and sepsis is suspected)
Antibiotic therapy
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
>37wks AND
membrane rupture <18h?
27. > 37 weeks AOG AND
duration of membrane rupture <18 h?
Observe for 48 hours
Some experts recommend a CBC
count with differential and platelets
at 6 to 12 hours of age.
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
>37wks AND
membrane rupture <18h?
28. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
29. < 37 weeks AOG OR
duration of membrane rupture >18 h?
Observe for 48 hours
Limited evaluation
blood culture (at birth) AND
CBC count with differential and platelets
(at birth and/or at 6–12 hours after birth)
COFN: no blood culture unless
antibiotics are started because of
abnormal laboratory data
Antibiotic therapy
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
>37wks AND
membrane rupture <18h?
<37wks AND
membrane rupture >18h?
30. < 37 weeks AOG OR
duration of membrane rupture >18 h?
If signs of sepsis develop
Full diagnostic evaluation
blood culture
CBC count, including white blood cell
differential and platelet counts
chest radiograph (if respiratory
abnormalities are present)
lumbar puncture (if the patient is
stable enough to tolerate procedure
and sepsis is suspected)
Antibiotic therapy
Signs of neonatal sepsis?
Maternal Chorioamnionitis?
GBS prophylaxis indicated?
4 hrs intrapartum antibiotics?
>37wks AND
membrane rupture <18h?
<37wks AND
membrane rupture >18h?
31. Secondary prevention of GBS disease
Algorithm for the prevention of early-onset GBS infection in the newborn
32. Prevention and Management of
Infants With Suspected or Proven
Neonatal Sepsis
Cristal Ann Laquindanum, MD-MBA
The Medical City
Pediatrics
NICU 2nd year resident