Thursday, June 23, 2011

Neonatal infections - Hemolytic streptococcus group B infection

This type of infection can occur early in the first 20 hours of life, orlate onset in the first week.
Colonization rate in pregnant women and newborn ranges from 5-35%. During the pregnancy, colonization may be constant, but can be intermittent.

The incidence is variable: 1-2% in term newborn, 5-8% inpremature.
The transmission is from mother to newborn during birth or rare inneonatal wards, the care staff colonized, probably by contaminatedhands.

clinical signs

Form with early onset disease is to install in the first 6 days, with an average of 24 hours.
Respiratory distress syndrome are different degrees to installapnea, shock. The patient may develop pneumonia, rarelyMenigos in 5-10% of cases.

Late-onset form occurs between 3-4 weeks, averaging between7saptamani-3 months, manifested with occult bacteremia ormeningitis.
Other modes of expression: osteomyelitis, septic arthritis, cellulitis


Intrapartum treatment protocol is based on risk factors:corioamniotita, if maternal temperature is above 38 ยบ C increasesthe incidence of disease at 6, 4%. If the membranes are rupturedmore than 18 hours should be instituted emergency care, giventhat the risk increases progressively after 12 hours of rupturedmembranes.
Prematurity is another risk factor, child under 36 weeks is twice as likely to get infections with streptococcus group B.
Maternal bacteriuria increases the risk of infection in newborns up to 8%.
If rectal or vaginal porting of maternal group B streptococcalneonatal sepsis risk is low in the absence of prematurity orruptured membranes.
If there are fractions with streptococcal infection at birth seems tobe high risk.

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