新生儿败血症（英文）-儿科教学课件.ppt

Neonatal Septicemia Bacteremia and Septicemia Bacteremia: a more benign infection with entrance of bacteria into the bloodstream, but in limited quantities. Septicemia: an overwhelming infection with more organism or more virulent organisms that is likely to lead to shock or other complications Term of (SIRS) The neonates does not localize infection well, and secondary spread to the meninges (meningitis) or other sites Incidence ranges from 1~10 patients per 1000 live births 10~40% of mortality and substantial morbidity in survival Etiology and Pathogenesis Pathogen: varies with region and time In USA and Europe: 1930s’ – Group A Strep 1940s’ – E. Coli 1950s’ – Staph aureus 1970s’ – Group B Strep In China: Staphylococcus, E. Coli Opportunistic pathogens Drug resistance Route of Infection Prenatal infection maternal bacteremia and septicemia invasive diagnostic procedures Intrapartum infection bacteria colonization in the parturient canal PROM, prolonged stages of labor Umbilical/fetal scalp sampling Postnatal infection enviroment, skin contact, medical procedures Neonatal Vulnerability Immature immune system skin/mucus membrane, low in IgG and complement, poor migration/phagocytosis, low in cytokine production Unavoidable pathogen exposure during birth Peripartum stress Invasive procedures Exposure to highly resistant nosocomial organisms Clinical Manifestation Most neonates with sepsis or meningitis present with NON SPECIFIC SIGNS OR SYMPTOMS Hypothermia/hyperthermia, respiratory distress, feeding difficulties, weak suck, irritability, lethargy, apnea, abdominal distension, vomiting, diarrhea, gallbladder distension, hepatosplenomegaly, jaundice, petechiae, seizure Clinical Manifestation Early-Onset (0~3d~7d) GBS E. Coli Listeria