新生儿脓毒症PPT课件
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NNP Network, 2005
Neonatal Sepsis
➢ Intramural admissions --Klebsiella pneumoniae (32.5%) --Staphylococcus aureus (13.6%)
➢ Extramural admissions --Klebsiella (27.5%) --S aureus (38%)
26.4 19.1:33.7 20 to 57.1
Late-onset Sepsis
25.0 23.6:26.3 0 to 53.7
13.3 11.2:15.4 1.8 to 35.6
NeoReviews, Vol.11, No.8, August 2010
Neonatal Sepsis
➢ Septicemia ➢ Pneumonia ➢ Meningitis ➢ Arthritis ➢ Osteomyelitis ➢ Urinary tract infection
NNF, India
Neonatal Sepsis- Incidence
➢ Incidence of EOS is 1-2 cases/1000 live births. ➢ This incidence is 10 fold higher in the VLBW infants. ➢ Incidence of early onset GBS has declined 80% from
Puopolo KM. NeoReviews 2008;9:e571-579
Neonatal Sepsis- Classification
➢ Early onset sepsis (<72 hours) ➢ Risk factors:
– Low birth weight – Febrile illness in the mother with in 2 weeks PTD – Fouls smelling amniotic fluid – PROM (>24 hours) – More than three vaginal exam during labor – Prolonged and difficult delivery with instrumentation – Perinatal asphyxia (apgar <4 at 1min) or difficult resuscitation – (presence of 3- treat, Presence of 2- sepsis screen)
➢ Incidence of systemic infection is 3% (India) with septicemia (75%) and pneumonia (25%)
NNP Network, 2005
Early– and Late-onset Sepsis
Infection Rate (%) 95% Confidence Interval Range*
NNF, India
Neonatal Sepsis- Definitions
➢ Culture positive sepsis --Isolation of the pathogen from blood, CSF, urine or abscess <72 hours of age
➢ Pathological evidence of sepsis on autopsy
新生儿脓毒症
Neonatal Sepsis
➢ Most common cause of neonatal mortality in developing countries.
➢ Up to 20% of neonates develop sepsis and 1% die of sepsis related causes.
Sankar et al. Indian j Pediatr.2008;75:261-6
Neonatal Sepsis- Definitions
➢ Probable sepsis (any one criteria): -Maternal fever or foul smelling amniotic fluid -PROM (> 24 hrs) or gastric polymorphs (>5 hpf) -Positive sepsis screen (any two criteria) -Total WBC count (<5000/mm or band/neutrophil ratio >0.2) -Total WBC count <1800/mm -C-reactive protein (CRP) >1mg/dl, micro ESR >10 mm-first hour -Radiological evidence of pneumonia
1.7 cases /1000 live births (1993) to 0.34/1000 live births (2005) due to intrapartum antibiotic prophylaxis. ➢ Mortality 2.6% in term and 35% in VLBW infants. ➢ Survivors of EOS may have severe neurologic sequelae attributable to meningitis, hypoxemia, septic shock, PPHN etc.
Aggarwal et al. India j Pediatr. 2001;68:1143-7
Mortality Rate (%) 95% Confidence Interval Range*
*Intra units (5 or more cases) Data from Valls-e-Soker A, et al. 2009 (5)
Early-onset Sepsis
3.6ห้องสมุดไป่ตู้3:4.1 0 to 10.5
Neonatal Sepsis
➢ Intramural admissions --Klebsiella pneumoniae (32.5%) --Staphylococcus aureus (13.6%)
➢ Extramural admissions --Klebsiella (27.5%) --S aureus (38%)
26.4 19.1:33.7 20 to 57.1
Late-onset Sepsis
25.0 23.6:26.3 0 to 53.7
13.3 11.2:15.4 1.8 to 35.6
NeoReviews, Vol.11, No.8, August 2010
Neonatal Sepsis
➢ Septicemia ➢ Pneumonia ➢ Meningitis ➢ Arthritis ➢ Osteomyelitis ➢ Urinary tract infection
NNF, India
Neonatal Sepsis- Incidence
➢ Incidence of EOS is 1-2 cases/1000 live births. ➢ This incidence is 10 fold higher in the VLBW infants. ➢ Incidence of early onset GBS has declined 80% from
Puopolo KM. NeoReviews 2008;9:e571-579
Neonatal Sepsis- Classification
➢ Early onset sepsis (<72 hours) ➢ Risk factors:
– Low birth weight – Febrile illness in the mother with in 2 weeks PTD – Fouls smelling amniotic fluid – PROM (>24 hours) – More than three vaginal exam during labor – Prolonged and difficult delivery with instrumentation – Perinatal asphyxia (apgar <4 at 1min) or difficult resuscitation – (presence of 3- treat, Presence of 2- sepsis screen)
➢ Incidence of systemic infection is 3% (India) with septicemia (75%) and pneumonia (25%)
NNP Network, 2005
Early– and Late-onset Sepsis
Infection Rate (%) 95% Confidence Interval Range*
NNF, India
Neonatal Sepsis- Definitions
➢ Culture positive sepsis --Isolation of the pathogen from blood, CSF, urine or abscess <72 hours of age
➢ Pathological evidence of sepsis on autopsy
新生儿脓毒症
Neonatal Sepsis
➢ Most common cause of neonatal mortality in developing countries.
➢ Up to 20% of neonates develop sepsis and 1% die of sepsis related causes.
Sankar et al. Indian j Pediatr.2008;75:261-6
Neonatal Sepsis- Definitions
➢ Probable sepsis (any one criteria): -Maternal fever or foul smelling amniotic fluid -PROM (> 24 hrs) or gastric polymorphs (>5 hpf) -Positive sepsis screen (any two criteria) -Total WBC count (<5000/mm or band/neutrophil ratio >0.2) -Total WBC count <1800/mm -C-reactive protein (CRP) >1mg/dl, micro ESR >10 mm-first hour -Radiological evidence of pneumonia
1.7 cases /1000 live births (1993) to 0.34/1000 live births (2005) due to intrapartum antibiotic prophylaxis. ➢ Mortality 2.6% in term and 35% in VLBW infants. ➢ Survivors of EOS may have severe neurologic sequelae attributable to meningitis, hypoxemia, septic shock, PPHN etc.
Aggarwal et al. India j Pediatr. 2001;68:1143-7
Mortality Rate (%) 95% Confidence Interval Range*
*Intra units (5 or more cases) Data from Valls-e-Soker A, et al. 2009 (5)
Early-onset Sepsis
3.6ห้องสมุดไป่ตู้3:4.1 0 to 10.5