After completion of this session the participant should be able to:
NYI have immature immune systems and have just been colonised with bacteria during their recent delivery. They are therefore prone to infections which are likely to cross barriers, for example between the lungs and blood and blood and meninges. Many NYI infections can be prevented by good hygiene at the time of birth, appropriate umbilical cord care, appropriate eye care, using KMC and avoiding separation of the mother and infant.
Common systemic bacterial infections in young infants include sepsis, pneumonia and meningitis and all these may present alike. Sepsis is a clinical syndrome of systemic illness accompanied by septicaemia (a bacterium in the blood which is normally sterile). It is also called bacteraemia.
The risk factors for sepsis in the NYI are:
The babies born to mothers with these risk factors may be symptomatic or asymptomatic. Both symptomatic and asymptomatic should be treated as having sepsis with IV antibiotics as the risk is so great and the mortality rates are high.
Key fact for providersInfants with sepsis may present in the first few days of life, before they have been discharged or they may go home and be readmitted with sepsis. The management of both groups is the same.
Lethargic, decreased movement
Axillary temperature 37.5°C or above (or feels hot to touch) or temperature < 35.5°C
Signs of respiratory distress in the newborn and in the YI: Grunting, nasal flaring, fast breathing, chest in drawing, crepitation’s in the lungs
Umbilical redness extending to the periumbilical skin or umbilicus draining pus
Look for these risk factors and do a sepsis screen. If the sepsis screen is negative and the infant remains asymptomatic, antibiotics may be discontinued after five days
WBC: < 5000 or > 20,000 cells/mcl (age >72 hrs)
Lumbar puncture if available, before IV antibiotics
Blood culture, if available, before IV antibiotics
Urine culture if available, before IV antibiotics
|Inj. Penicillin or||50,000 IU/kg||< 7 days:
|> 7 days:
|Inj. Gentamicin||LBW 3mg/kg/dose Term 5mg/kg/dose||< 7 days:
|> 7 days:
Key fact for providers - Supportive care for NYI with sepsis