OTHER NEONATAL/INFANTILE INFECTIONS


I. Congenitally vs.Perinatally acquired infections

Congenitally transmitted Perinatally transmitted
Rubella Group B streptococcus
Toxoplasmosis Herpes simplex
HIV Chlamydia
Syphilis Gonorrhea
Parvovirus Hepatitis B
Listeria Listeria
CMV CMV
Varicella Varicella
E. Coli  

II. Treatment of baby born to mom with chorioamnionitis

  1. Mom usually gets antibiotics in labor, so fetal cultures are unreliable
  2. In a study of 168 neonates >2kg birthweight whose moms got abx for chorio, all of whom got sepsis w/u at birth, were started on abx, and had repeat CBC 1-2d later, and given abx for 7d if any clinical or lab evidence of infection (o/w stopped at 72h then observation off abx for 1-2d more), 4 pts, all in 7-d tx group, had pos. cx; one was clinically well and had nl CBC; All pts did well at one month (Arch. Ped. Adol. Med 150:158, 1996)
  3. In a study of 856 near-term or full-term newborns whose mothers had had abx for high intrapartum temperatures, CBC parameters (done on all at 1h, 12h, and 24h postpartum) were not reliable predictors of eventual diagnosis of sepsis (Peds. 113:1173, 2004--JW)