Author/Editor     Kornhauser-Cerar, Lilijana; Mole, Helena
Title     Klinika okužb pri novorojenčkih
Translated title     Neonatal infections - clincal manifestations
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 45, št. Suppl 3
Publication year     2006
Volume     str. 31-6
Language     slo
Abstract     The incidence of infection is higher in the neonatal period than at any other time in life and infections contribute to neonatal morbidity and mortality substantially. They are attributable to increased exposure to maternal organisms during delivery (colonizing the genital tract and rectum), to the immaturity of immune mechanisms, and increased susceptibility of the skin and mucous surfaces to trauma. The clinical signs of neonatal bacterial sepsis are non-specific and may be clinically indistiguishable from those occuring in non-infectious conditions, as well as being very similar to the signs of severe viral and fungal infections. Early-onset infection (within 48 hours of birth) is often associated with respiratory distress and babies are more likely to be shocked, whereas the onset of symptoms in late-onset sepsis is often more insidious. Peripartum primary maternal viral infection is associated with severe disease in newborn, which can be rapidly fatal. Fungal infections mainly affect preterm infants, particularly those who have received prolonged treatment with antibiotics, total parenteral nutrition, or needed ventilatory support. As rapid deterioration is usual in the newborn with bacterial sepsis, empirical treatment with antibiotics must be started early on suspicion of sepsis.
Summary     Okužbe so v obdobju novorojenčka pogostejše kot kadarkoli kasneje in so pomemben vzrok obolevnosti in umrljivosti. Povezane so s povečano izpostavljenostjo ploda in novorojenčka patogenim mikroorganizmom (zlasti iz porodne poti v času rojstva), nezrelostjo obrambnih mehanizmov ter ranljivostjo kože in sluznic. Klinični znaki so v obdobju novorojenčka neznačilni in jih je težko ločiti od znakov drugih bolezni, pray tako so si podobni znaki težkih bakterijskih, glivičnih ali virusnih okužb. Glede na čas pojava znakov govorimo o zgodnji (v prvih 48 urah) in kasni bakterijski okužbi. Za prvo je značilna prizadetost dihal z znaki dihalne stiske, pogosto je tudi šokovno stanje; potek kasnih okužb je lahko postopnejši. Če mati zboli s primarno virusno okužbo v obporodnem obdobju, je okužba novorojenčka težka in se pogosto konča s smrtjo. Glivične okužbe prizadenejo predvsem nedonošenčke, ki so dolgotrajno zdravljeni z antibiotiki, umetno ventilirani in prejemajo popolno parenteralno prehrano. Ker bakterijska sepsa lahko hitro privede do življenjske ogroženosti, je že ob sumu nanjo nujno empirično zdravljenje z antibiotiki.
Descriptors     INFANT, NEWBORN, DISEASES
SEPSIS
BACTERIAL INFECTIONS
VIRUS DISEASES
MYCOSES
INFANT, NEWBORN