Infectious Diseases

We have a baby diagnosed at birth with tracheo-esophagela atresia and was operated on the second day of life. Post-op, patient started deteriorating with respiratory failure, needing inotropic support with mottled skin, and was clinically septic. Blood culture was taken that day and grew acinetobacter spp. resistant to all antibiotics tested (3rd gen cephalosphorins, ciprofloxacin, tienam, meropenem, aminoglycosides, ticarcillin). Though we have started the patient already on Tienam and Vancomycin prior to this culture result. Then on we changed vancomycin to amikacin..but repeat culture still showed the same organism. The ICD tube inserted by the surgeon post-op was drai…

I have a suspected sepsis in the air pipe system, how can I sterilize the air pipe system??

There are lot of literature revealing a high incidence of seizures when imipenem/cilastin is used among patients with meningitis. We frequently use imipenem in our neonates with gram negative septicemia, so long as the culture and sensitivity report shows the organism to be sensitive to imipenem. Often the neonate is too critical for a lumbar puncture. Most probably many of our neonates with septicemia may also have had CNS involvement . However we have so far not noticed nay seizure activity in any of our neonates receiving imipenem. What does this mean? One, possibility is that all the neonates who got imipenem never had meningitis...Possible! The other po…

How strictly does your unit enforce the no fake nail or nail polish rule? There has been recent studies fake nails and nail polish harbour huge amounts of bacteria.

Dear colleagues, Could you share your practise of empirical AB choice in your NICU when you suspect late onset sepsis. I will appreciate also if you add: 1.Time definitions of LOS in your NICU. 2. Rate of LOS in VLBW group in NICU. 3. No of beds in NICU. 4. No of admissions per year. I believe that LOS is one of biggest issues in many places were tiny babies are in care.Thank you in advance for your responses. ------- Audrius Kaunas Medical University Hospital, Lithuania

A baby two months old , born by normal vaginal delivery , breathed spontaneously at birth and was a full term delivery, parents were not related and it was their first baby, no history of abortions, pregnancy course was uneventfull. Baby was ok since birth , developing and thriving well, but with mottled, mrble like skin all over the body, no change in response to warming but increae with exposure to cold . at one month of age was presenting with moderate fever and was admitted to hospital mainly because of his mottled skin: screening for infections were done , in addition to thromboembolic screen; were all negative, discharged home with oral antibiotics, afer which he i…

Dear friends: There is a preterm baby who has stayed in our NICU almost four weeks.His gestation is 30 weeks. Shortly after birth, baby presented respiratory distress and was supported by CPAP, Chest X-ray indicated pneumonia.Because of repeated apneas,CPAP was replaced by ventilation.Meanwhile antibiotic was used. A week later,x-ray showed pneumonia improved ,ventilator was removed. Baby did not present remarkable respiratory distress ,repeated apneas of the baby remained. This situation lasted several days, we had to use CAPA again. However,this measure did not reduce frequence of apneas, after a week,the baby`s statement went worse,frequence of apneas arised …

Dear all, consider the following scenario: a non-immune pregnant woman is incubated with morbilli around the time of birth. I'd be happy to hear about your experience/guidelines about maternal/congenital morbilli, especially your policies regarding immunoglobulin and immunization of the mother/child.

Hi All I have a newborn with Congenital Rubella Syndrome (IUGR, Cataract, Small ASD, PDA, Thrombocytopenia, Periventricular Calcifications, Sensorineural deafness, Rubella IgM +ve). I would like to know how long does the thrombocytopenia last. How do I treat it? (Platelet transfusions v/s IV IgG). When do I start immunisation?