Microbiology of neonatal and childhood infections
Microbiology of neonatal and childhood infections
- Created by: jeejay
- Created on: 28-12-13 15:20
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- Microbiology of neonatal and childhood infections
- Congenital infections
- transmitted vertically from mother to child
- can occur any time during pregnancy
- varied presentation, non specific signs, wide range of severity, serological diagnosis,
- examples of clinical features, rash, thrombocytopaenia, cerebral abnormalities, microcephaly, hepatosplenomegaly, hepatitis, jaundice
- varied presentation, non specific signs, wide range of severity, serological diagnosis,
- Toxoplasmosis, Rubella, HIV, Hepatitis B, syphilis, Torch, Toxo, other, rubella, cytomegalovirus, HSV, HIV
- Toxoplasmosis 60% asymtomatic at birth, long term sequealae, deafness, low iq, microcephaly, 40% symptomatic choroidenitis, microcephaly, hydrocephalus, intracranial calcification, seizure, jaundice, hepatosplenomegaly
- Congenital rubella syndrome, mitotic arrest of cells, angiopathy, growth inhibitor effect
- eyes, cataracts, microphtalmia, glaucoma, retinopathy, cardiovascular disease, pda, pas, asd, vsd
- ears, deafness, brain, microcephaly, developmental delay , bone disease, growth retardation, hepatosplenomegaly, thrombocytopenia, rash
- cmv, hsv, rash
- Neonatal infections
- 1st 6 weeks of life, if born early, adjusted to for expected birth date, can become ill rapidly, treat at first site of infection,
- immature host defence, less maternal IgG there is early and late onset,
- Early onset, within 48 hours of birth
- Group B strept
- gram + catalase negative, beta haemolytic, lancefield group b, bacteraemia, meningitis, joint infection
- e. coli
- gram negative, meningitis, uti
- Listeria monocytogenes
- investigations
- fbc, crp, blood culture, deep ear swab, csf, surface swabs, cxr
- Ventilation ? Circulation ? Nutrition ? Antibiotics: e.g. benzylpenicillin & gentamicin
- early onset sepsis risk factor
- mternal
- preterm labour
- fever
- foetal distress
- meconium staining
- previous history
- baby
- aphyxia
- resp distress
- mternal
- Group B strept
- Late onset
- group b strept
- listeria monocytogenes
- s, ureus
- enterococci
- gram negatve
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- fbc, crp, blood culture, urine, et secretions if ventilated,
- Review and stop antibiotics if cultures negative and clinically stable ? NICU-Example of antibiotics for late onset sepsis: ? 1st line: Flucloxacillin & gentamicin ? 2nd line: Pipericillin/tazobactam & vancomycin ? Community acquired late onset neonatal infections: cefotaxime, amoxicillin +/-gentamicin
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- Early onset, within 48 hours of birth
- immature host defence, less maternal IgG there is early and late onset,
- 1st 6 weeks of life, if born early, adjusted to for expected birth date, can become ill rapidly, treat at first site of infection,
- Infections during childhood
- recurrent infections
- Infections during childhood
- Viral infections are very common e.g. Chickenpox (VZV); Herpes simplex – cold sores/stomatitis; HHV6; HHV8; EBV; CMV; RSV; enteroviruses etc
- Common non-specific symptoms: ? Fever ? Abdominal pain
- Investigations: ? FBC ? CRP ? Blood cultures ? Urine ? +/- Sputum; throat swabs etc
- MEningitis
- 1. clinical features
- rash occurs
- Blood cultures ? Throat swab ? LP for CSF if possible ? Rapid antigen screen ? EDTA blood for PCR ? Clotted serum for serology if needed later#
- Raised WCC – mainly polymorphs? Gram stain – may see organisms e.g. meningococci; pneumococci etc. ? High protein and low glucose ? Rapid Antigen test on CSF may be positive. ? Culture may grow the organism – yields sensitivity data ? If it doesn't grow, PCR may be positive
- 1. clinical features
- Streptococcus pneumniae
- gram + pneumonia, bacterameia meningtitis
- vacinnation programme in 2000
- Congenital infections
- FINSIH THIS
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