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Sepsis neonatal por Estreptococos Pyogenes
Rodríguez-Herrera,Gilberto; Ramírez-Navarro,Cinthya;
Acta Médica Costarricense , 2009,
Abstract: we present herein the case of a newborn patient of appropriate gestational age weight ( 3700 grams), born by vaginal delivery, from a mother that had had 2 previous pregnancies (2 normal deliveries). during the immediate puerperium she had fever. the parents consulted at the age of 2 days, stating that they had noticed difficult breathing since his birth, hipoactivity and poor appetite. he was admitted to the hospital and underwent several studies searching for the origin and germ causing the sepsis. he developed respiratory failure and needed mechanical ventilation for several days on different occasions. he had exudative pleural effusion and hypoxic ischemic seizures. later on, his blood cultures were positive for streptococcus pyogenes. streptococcus pyogenes or streptococcus β- hemolytic group a infection, used to be a common entity in the beginning of the past century, it was commonly associated with puerperal infections and newborn infections, but its incidence declined and nowadays, is uncommon during the neonatal period. its clinical manifestations could vary from chronic omphalitis up to a low grade septicemia or fulminant meningitis. since its incidence has declined, at the present time; is an unusual infection of the neonatal period. ampicillin and gentamicin are currently recommended as first-line antimicrobials, ampicillin replacing the previously recommended penicillin.
Morbilidad y mortalidad por sepsis neonatal precoz
Fernández Díaz,Nayvi; Duque de Estrada Riverón,Johan; Díaz Cuéllar,Fe;
Revista Cubana de Pediatr?-a , 2010,
Abstract: introduction. a retrospective, cross-sectional and descriptive study was conducted during the five-year period between january, 2003 and december, 2007. the aim of present paper was to characterize the behavior of the newborn (nb) diagnosed with early neonatal infection seen in the neonatal intensive care of gynecology and obstetrics teaching provincial hospital, matanzas province. methods. study group included 13 362 live birth newborn documented from 2003 to 2007. sample also included all newborn admitted in the neonatal intensive care unit. results. incidence and mortality rates from this cause showed a raise during the five-year period. patients diagnosed were mainly of low-weight male sex, white race and pre-term. in more than a half of the cases there were risk perinatal factors registered. the more frequent presentation way was the systemic sepsis. the complementary examinations were positive in the quarter of patients. the use of dobutamine is lower than it is prescribed for treatment of neonatal sepsis and the mechanical ventilation usually is complicated. conclusions. there are solid theoretical basic principles supporting the need to develop an action protocol to decrease the morbidity and mortality rate from early neonatal sepsis.
Diagnosis of Neonatal Bacterial Sepsis by Polymerase Chain Reaction  [PDF]
Amany E. Elwan,Wahiba A. Zarouk
Journal of Biological Sciences , 2009,
Abstract: The aim of this study is to find out a faster way with considerable sensitivity and specificity using a Polymerase Chain Reaction (PCR) for detecting bacterial DNA encoding 16S RNA. A broad range PCR without preincubation was compared to conventional diagnostic work up for clinical sepsis, including blood culture, for early determination of bacterial sepsis in 75 neonates with suspected neonatal sepsis. Also, the relationship between clinical signs and laboratory parameters were explored. According to blood culture results patients were classified into blood culture positive and negative groups. Blood culture positive group were 39 newborns of them 36 had PCR positive and 26 had sepsis screen positive. Blood culture negative group were 34 newborns of them 4 had PCR positive and 7 had sepsis screen positive. Compared to blood culture sepsis screen showed sensitivity 66.6%, specificity 79.4%, positive 78.7% and negative predictive value 67.5% in diagnosis of neonatal sepsis while PCR compared to blood culture showed sensitivity of 92.3%, specificity of 88.2%, positive predictive value 90% and negative predictive value 91%. Two patients were excluded from the study as their blood culture showed Candida albicans. With results available within 4 h, PCR had more sensitivity and specificity than sepsis screen in diagnosis of neonatal sepsis. PCR has potential for early detection of bacterial DNA encoding 16S RNA but this needs further development and improvement. Blood culture is still irreplaceable at present, since pure isolates are essential for antimicrobial drug susceptibility testing.
Sepsis neonatal por Streptococcus Grupo B
CRUZ O,MAGDALENA; DOREN V,ADRIANA; TAPIA I,JOSé LUIS; ABARZúA C,FERNANDO;
Revista chilena de pediatría , 2008, DOI: 10.4067/S0370-41062008000500003
Abstract: group b streptococcus is one of the leading bacterias causing early onset neonatal sepsis. it constitutes an important factor of neonatal morbidity and mortality and high costs in health. many strategies have been formulated to avoid vertical transmission from the colonized mother to the newborn, in an attempt to prevent infection of the infant. the most used nowadays is antibiotic prophylaxis given to the mother during labor, depending on the results of recto-vaginal culture taken during 35 to 37 weeks of gestation. this strategy has importantly diminished the prevalence of early onset neonatal sepsis by this agent, although there is still concern about the potential generation of antibiotic resistance and drug-induced adverse reactions in the mother. new techniques for prevention are being developed, such as vaccines against streptococcus. in the newborn, infection caused by streptococcus has a broad spectrum of clinical manifestations, like sepsis and meningitis which are the most frequent and lethal. neurological sequelae are common among the survivors, so an early suspicion of disease must lead to a prompt antibiotic treatment.
Sepsis neonatal tardía por Streptococcus pyogenes
Fari?as Salto,Mercedes; De la Huerga López,Aída; Menéndez Hernando,Cristina; López,Ester Sanz;
Archivos argentinos de pediatr?-a , 2011,
Abstract: currently, the group a streptococcus is a unusual cause of infection in the neonatal period. the description of cases of severe infection in the newborn is sporadic. we present a 12-days-old newborn attended at the emergency room for fever without focus, which developed neurological and systemic involvement during admission. clinical presentation, evolution and treatment are described. blood culture isolation of group a streptococcus confrmed late sepsis by this bacteria, probably with associated meningitis.
Sepsis neonatal en la era de profilaxis antimicrobiana prenatal
Tapia I,José Luis; Reichhard T,Cristina; Saldías R,M. Isabel; Abarzúa C,Fernando; Pérez A,M. Eugenia; González M,álvaro; Gederlini G,Alessandra;
Revista chilena de infectología , 2007, DOI: 10.4067/S0716-10182007000200004
Abstract: the aim of this study was to compare incidence, bacteriology and associated mortality of neonatal sepsis in a neonatal unit, after (2001-2004) and before (1995-1996) implementation of universal screening for prevention of group b streptococcus diseases. early onset sepsis incidence decreased from 2.5 to 1 per 1000 live births (p = 0.03), with a decrease in the proportion of group b streptococcus cases from a 54% to 11% (p < 0.01). in late onset sepsis, coagulase-negative staphylococci continued to be the predominant pathogen (49% of cases), and candida albicans emerged as the second etiologic agent in the postscreening period. sepsis associated mortality was low in both periods (2.2%)
Compliance With Protocols for Prevention of Neonatal Group B Streptococcal Sepsis: Practicalities and Limitations  [PDF]
Gwendolyn L. Gilbert,Moira C. Hewitt,Catherine M. Turner,Stephen R. Leeder
Infectious Diseases in Obstetrics and Gynecology , 2003, DOI: 10.1155/s1064744903000012
Abstract: Objective: To compare two protocols for intrapartum antibiotic prophylaxis (IAP) against neonatal group B streptococcal (GBS) sepsis, with respect to staff compliance, in a prospective cohort study in the obstetric units of a community hospital (A) and a university teaching hospital (B).
Sepsis neonatal cervicomaxilofacial (1996 a 2005)
López Díaz,Zoila del S.; Pla Ampudia,Mirtha;
Revista Cubana de Pediatr?-a , 2007,
Abstract: a retrospective and longitudinal study of cervicomaxillofacial sepsis in the neonates admitted in our intensive care unit in a period of 10 years was conducted. an average incidence of 1.20 per 100 admissions, as well as the predominance of white female infants aged 7-27 days old (late sepsis) were observed. facial cellulitis was caused by obstetric trauma and it was the most frequent diagnosis. no relation between the presence of sepsis and gestational age, apgar score, or birth weight, was found, since in most of the children these results were within the normal limits. the most used treatment was the antibiotic therapy with the association of 2 or more antibiotics. the combination of penicillin and gentamicin was the most common treatment. in those cases, among whom the sepsis had a very severe systemic repercussion, immunoglobulin therapy was also applied. the evolution was satisfactory in 100 % of the cases, most of whom had to be admitted for 7 days. no deaths were reported.
Effect of case management on neonatal mortality due to sepsis and pneumonia  [cached]
Zaidi Anita K M,Ganatra Hammad A,Syed Sana,Cousens Simon
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-s3-s13
Abstract: Background Each year almost one million newborns die from infections, mostly in low-income countries. Timely case management would save many lives but the relative mortality effect of varying strategies is unknown. We have estimated the effect of providing oral, or injectable antibiotics at home or in first-level facilities, and of in-patient hospital care on neonatal mortality from pneumonia and sepsis for use in the Lives Saved Tool (LiST). Methods We conducted systematic searches of multiple databases to identify relevant studies with mortality data. Standardized abstraction tables were used and study quality assessed by adapted GRADE criteria. Meta-analyses were undertaken where appropriate. For interventions with biological plausibility but low quality evidence, a Delphi process was undertaken to estimate effectiveness. Results Searches of 2876 titles identified 7 studies. Among these, 4 evaluated oral antibiotics for neonatal pneumonia in non-randomised, concurrently controlled designs. Meta-analysis suggested reductions in all-cause neonatal mortality (RR 0.75 95% CI 0.64- 0.89; 4 studies) and neonatal pneumonia-specific mortality (RR 0.58 95% CI 0.41- 0.82; 3 studies). Two studies (1 RCT, 1 observational study), evaluated community-based neonatal care packages including injectable antibiotics and reported mortality reductions of 44% (RR= 0.56, 95% CI 0.41-0.77) and 34% (RR =0.66, 95% CI 0.47-0.93), but the interpretation of these results is complicated by co-interventions. A third, clinic-based, study reported a case-fatality ratio of 3.3% among neonates treated with injectable antibiotics as outpatients. No studies were identified evaluating injectable antibiotics alone for neonatal pneumonia. Delphi consensus (median from 20 respondents) effects on sepsis-specific mortality were 30% reduction for oral antibiotics, 65% for injectable antibiotics and 75% for injectable antibiotics on pneumonia-specific mortality. No trials were identified assessing effect of hospital management for neonatal infections and Delphi consensus suggested 80%, and 90% reductions for sepsis and pneumonia-specific mortality respectively. Conclusion Oral antibiotics administered in the community are effective for neonatal pneumonia mortality reduction based on a meta-analysis, but expert opinion suggests much higher impact from injectable antibiotics in the community or primary care level and even higher for facility-based care. Despite feasibility and low cost, these interventions are not widely available in many low income countries. Funding This work was suppo
Compliance With a Protocol for Intrapartum Antibiotic Prophylaxis Against Neonatal Group B Streptococcal Sepsis in Women With Clinical Risk Factors  [PDF]
Toni R. Sanders,Christine L. Roberts,Gwendolyn L. Gilbert
Infectious Diseases in Obstetrics and Gynecology , 2002, DOI: 10.1155/s1064744902000261
Abstract: Objective: The aim of this study was to determine the prevalence of clinical risk factors (CRF) for neonatal sepsis in laboring women and to evaluate clinician compliance with a CRF-based protocol for intrapartum antibiotic prophylaxis (IAP).
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