Neonatal Sepsis

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Neonatal Sepsis :

Clinical features of Sepsis and bacteremia.

1. Lethargic
2. Feeding difficulty
3. Seizures

Early ( <72hrs )	Late ( >72 hrs )
Pneumonia more common	Septecemia , Meningitis is common , Pneumonia. Therefore LP is done
Maternal Risk factors Maternal fever <2wks Maternal foul smelling liquor Premature rupture of membrane Maternal Pain abdomen Chorioamnitis Multiple Vaginal examinations in mother	Nosocomial
Organisms : E.Coli , Group B Sterptococcus	Klebsiella , Listeria , E.Coli
Treatment : Ampicillin + Gentamycin	3rd Generation cephalosporins Cefotaxime + Amikacin

Overall MC organism - Klebsiella
2nd MC - Staphylococcus Aureus

Sepsis Screen for early diagnosis :
1. TLC : < 5000 /cumm (More Suggestive)
              > 5000 /cumm

2. Absolute Neutrophil count : <1500 / cumm

3. Peripheral Smear for band cells (immature neutrophil) & toxic granules : >20% of total neutrophils

• Thus I / T : >0.2 (Immature / Total Neutrophil )

4. Micro ESR : >15 mm fall in 1st hour

5. CRP : +ve

6. LP : in Late onset sepsis

7. CxR

Antibiotics Course duration
Bacteremia : 10-14 days
Meningitis : 3wks
Arthritis ; Osteomyelitis : 4-6wks

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