Let's be positive
Early onset sepsis with this gram positive cocci can be reduced with intrapartum antibiotics
What is Group B streptococci (S. agalactiae)
This gram negative rod is the most common cause of early onset sepsis.
What is E. coli?
Julie brings her 2 week old baby in for its well baby visit and mentions she has noticed a few "water blisters". In addition to viral cultures/PCR and admission for therapy she is horrified when you suggest what else will need to be done as part of management?
What is a lumbar puncture?
It is July and a frantic OB intern calls you for advice. Julie, G1P0, just showed up in labor after having no prenatal care due to being strung out on opioids. Name 3 risk factors that would warrant antibiotic prophylaxis for GBS?
What are 1. gestational age <37 weeks 2. amniotic rupture of membranes >18 hours 3. Intrapartum fever >100.4 F (38.0 C)?
These infections require exclusion of breast feeding including expressed milk from mother. (In US and other resource rich countries)
What is HIV, HTLV 1 and 2 and Ebola?(Temporary exclusion for HSV lesions on breast, untreated brucellosis, women in airborne cannot breast feed but expressed breast milk is fine)
Mechanism for methicillin resistance in staphylococci.
What is mec A gene, changes in PCN binding protein (PBP-2a)?
Bad luck baby girl Jones just got diagnosed with gram negative meningitis and head ultrasound suggests multiple brain abscesses. Dr. Smart, the attending tells the fellow to start meropenem for this reason.
What is the baby may have Citrobacter which is known to cause brain abscesses and is frequently multi drug resistant?
Julie delivers a healthy full term baby boy but has fever and hepatitis after delivery. At 6 days of age the baby develops seizures, pneumonitis and severe hepatitis. This drug should be started immediately.
What is acyclovir?
What positive culture/infection in the mother during a previous pregnancy only would be an indication for GBS antibiotic prophylaxis during the current pregnancy?
What is none. (a previous infant with invasive disease would be an indication)
Name an enzyme deficiency that results in severe combined immune deficiency (SCID)
What is adenosine deaminase or purine nucleoside deficiency?
This bad boy is associated with lipids and late onset sepsis.
What is coagulase negative staphylococci?
Earth muffin mom delivers baby boy after uncomplicated birth plan and you are shocked she is not breast feeding. You are also shocked to see this gram negative coccobacillus grow in blood when this baby develops signs of sepsis at 7 days of life.
What is Haemophilus influenzae?
Julie had fever one week prior to delivering a healthy full term baby boy. At 6 days of age the baby develops seizures, severe hepatitis and a macular papular rash. What specific virus could this be?
What is echovirus?
Julie was found to have a positive GBS test at 35 weeks and now has delivered a 37 week healthy infant 2 hours after receiving a dose of ampicillin and with 15 hours of ruptured membranes. This is the recommended f/u for the baby.
What is observation for 48 hours? (some experts would get a CBC with diff and platelets at 6 and 12 hours of life)
This toxin results in generalized exfoliation in the neonate, tender scarlatinaform eruption and localized bullous impetigo in older children or a combination of these with thick white/brown flaky desquamation of the entire skin in older infants and toddlers.
What is exfoliative toxin?
Julie complained of a "flu-like" illness with back pain late in pregnancy and her infant now is febrile with a papular rash. Blood culture is showing slender gram positive rods. What is the infection?
What is listeriosis?
The 5 most common gram negative rods associated with inducible Amp C resistance.
What are Serratia, Pseudomonas, Acinetobacter, Citrobacter and Enterobacter?
Baby Boy Happy is admitted from ER at 3 weeks of age for apnea. He was born FT without complication. CSF has 0 WBC and normal glucose and protein. The enteroviral and HSV PCR are negative. You are surprised to see a positive detection of what virus on the multiplex PCR of CSF?
What is parechovirus?
Bad luck baby girl Jones was treated for GBS sepsis at one day of life for 10 days and now at 6 weeks of age is diagnosed with bacterial meningitis. Name the most likely organism?
What is Group B strep?
Mrs. Smith is convinced that bad luck baby girl smith got ill after drinking bad formula she purchased from the Dollar General store. You are not so sure she is wrong after seeing this gram negative rod growing in blood culture.
What is C. sakazakii?