An infection of the newborn can be acquired in utero transplacental or rupture in the birth canal during delivery (intrapartum) From other sources after delivery (postpartum) In utero comes the infection, which can take place at any time before birth, either an obvious or subclinical maternal infection forth. The consequences depend on the polluter and the duration of pregnancy, and can spontaneous abortion, intrauterine growth retardation, premature birth, stillbirth, congenital anomalies (eg. As rubella) and symptomatic (z. B. cytomegalovirus [CMV] toxoplasmosis, syphilis) or asymptomatic infections ( z. B. CMV) lead the newborn. Common viral pathogens are herpes simplex virus, HIV, CMV, and hepatitis B. Intrapartum infection with HIV or hepatitis B occur in the passage by an infectious birth canal or ascending infections caused by a birth delay in premature rupture before. These viral infections can be transmitted in less frequent cases through the placenta. CMV is generally transmitted through the placenta. Bacterial culprits are group B streptococci, gram negative enterococci (v. A. Escherichia coli), Listeria monocytogenes, gonorrhea and chlamydia. The postpartum infections are caused by direct contact with the mother (such as tuberculosis, which is also sometimes transmitted in utero) through breastfeeding (eg, HIV and CMV.) Or by contact with nurses or hospital environment causes (numerous pathogens – acquired in the hospital infections in newborns). In utero infection in utero infection, which can take place at any time before birth dates, her either an overt or subclinical maternal infection. The consequences depend on the polluter and the duration of pregnancy, and can spontaneous abortion, intrauterine growth retardation, premature birth, stillbirth, congenital anomalies (eg. As rubella) and symptomatic (z. B. cytomegalovirus [CMV] toxoplasmosis, syphilis) or asymptomatic infections ( z. B. CMV) lead the newborn. Some common infectious agents that are transmitted transplacental include rubella, toxoplasmosis, CMV and syphilis. HIV and hepatitis B are less frequently transmitted through the placenta. Intrapartum infection Neonatal infections with herpes simplex virus, HIV, hepatitis B, group B streptococci, gram-negative enterococci (especially Escherichia coli), Listeria monocytogenes, gonorrhea and chlamydia usually occur by passage through an infected birth canal on .. sometimes an ascending infection can occur if the delivery after the break of membranes is delayed. Postpartalinfektion The postpartum infections are caused by direct contact with the mother (such as tuberculosis, which is also sometimes transmitted in utero) through breastfeeding (eg., HIV and CMV) or caused by contact with the family or visitors, nurses or hospital environment ( numerous pathogens – hospital-acquired infections in newborns). Risk factors for infection of the newborn The risk of intra- or postpartum infection is inversely proportional to the duration of pregnancy. Newborns are immunologically immature and have a reduced polymorphonuclear leukocyte and monocyte function and a cell-mediated immune response. Premature babies are more sensitive (Perinatal Physiology: Immune function). Maternal IgG antibodies cross the placenta, but a high enough quantity for all pathogens is present just before the expected date. IgM antibodies do not cross the placenta. Premature babies have a decreased intrinsic antibody production and reduced activation of complement. Premature infants are at risk by more invasive treatment methods (eg. B. intubation, intravenous routes). Symptoms and signs Symptoms in newborns are usually non-specific (eg. As vomiting or poor nutrition, increased drowsiness or lethargy, fever or hypothermia, tachypnea, rashes, diarrhea), swollen abdomen. Many congenital infections are acquired before birth and bring different symptoms or abnormalities with it (eg., Growth failure, deafness, microcephaly, malformations, failure to thrive, hepatosplenomegaly, neurological abnormalities). Diagnosis Clinical examination A variety of infections, including sepsis, should be considered in newborns who are sick at birth or shortly thereafter, especially in those with risk factors. In newborns with abnormalities such as growth retardation, deafness, microcephaly, malformations, hepatosplenomegaly or neurological abnormalities particular care should be on infections such. As congenital rubella, syphilis, toxoplasmosis and CMV are respected. Treatment Antimicrobial therapy The very first treatment at putative bacterial infection in newborns is an empirical prompt antimicrobial therapy with drugs such as ampicillin and gentamicin and ampicillin, and cefotaxime. The final choice of drugs based on the results of cultures and is similar in adults because the infectious organisms and their antibiotic sensitivity are not different from those of the newborns. However, the medication dose and frequency of numerous factors depend, including age and weight (see Table: Recommended doses of selected pareneraler antibiotics for newborns and see Table: Recommended dosage of selected oral antibiotics for newborns *).

Health Life Media Team

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