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Neonatology:
NeonatalSepticemia
LecturepointsMorbidityandmortalityThecompromisedhostoftheneonatesinimmunologyPathogensforclinicalconsiderationClinicalmanifestationClinicalManagement2
Incidence1%～10%,inlivebirth15-20%,inVLBW3
Incidence‰‰GrossincidenceComparison:USanddevelopingcountries4
NeonatalSepticemiaDeathrate:US5
NeonatalSepticemiaDeathrate：developingcountriesLONS7.5%deathrate:9.8%~12%6
ImmaturedevelopmentinbodydefenseImperfectfunctionLessexperienceofexposuretoenvironmentandpathogensAffectedbymaternalantibodiesImmunologicalfeatures
inneonates7
Non-specificImmune:PoorbarriersfunctionUndevelopedcomplementactivationcapacityRelativefewerneutrophil,ImmaturefunctionLowerILs,lowerlevelofcytokinesImmunologicalfeatures
inNeonates8
SpecificImmune:QuantitiesandqualityofIgG,A,MT,Bcell:quantities,qualityandtheirfunctionImmunologicalfeatures
inNeonates9
PathogensDomestic:Staphylococcus:mostcommonlyseenEscherichiacoli,etc.G-bacillusUS:GBS:theleadingpathogenduring1970’sEscherichiacoli:theleadingpathogenduring1990’s10
PathogenicChanges‰EONS:ChangesbyG+vs.G-Early1990’sLate1990’s11
PathogenicChanges12
RelevantfactorsofpathogenicchangesChangeofcolonizedpathogensinmaternalbirthcanalGBSScreeningPreventiveantibiotictherapyusedduringprepartumAmpicillineforthemotherwithGBSpositive:prepartumandIntro-partumGBSSepticemia?Efficacy：around70%（vs.controlP0.0001）13
Pathogensbasedonthetypes
indevelopedcountryEONS：E.coliListeriamonocytogenes,PseudomonasMeningococcusEnterococcusandGBSLONS：Coagulase-negativeStaphylococcusHaemophilusinfluenzabacillusOtherpathogens14
Pathogensbasedonthetypesindevelopedcountry15
LONS(48hoursafterbirth)Mainly:G+Coagulase-negativeStaphylococcusPartlyreported：Staphylococcusepidermidis,GBS
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