I-sepsis engakhulelwa

I-sepsis yeNonatal yintsholongwane yegazi eyenzeka kusana olungaphantsi kweentsuku ezingama-90 ubudala. I-sepsis yokuqala kwangoko ibonwa kwiveki yokuqala yobomi. Ukuqala kwexesha lespsis kwenzeka emva kweveki enye ukuya kwiinyanga ezi-3 ubudala.

I-sepsis ye-Neonatal inokubangelwa ziibhaktheriya ezinje Escherichia coli (E coli), IListeria, kunye nezinye iintlobo ze-streptococcus. I-streptococcus yeqela B (i-GBS) iyeyona nto ibangele isifo se-neonatal sepsis. Nangona kunjalo, le ngxaki iye yaxhaphaka kancinci kuba abafazi bayakhangelwa ngexesha lokukhulelwa. Intsholongwane ye-herpes simplex (HSV) nayo inokubangela usulelo olunzima kusana olusandul 'ukuzalwa. Oku kwenzeka kakhulu xa umama esanda kusuleleka.

Ukuqala kwangaphambi kokubeleka kwe-sepsis kuhlala kubonakala ngaphakathi kweeyure ezingama-24 ukuya kwezi-48 zokuzalwa. Usana lufumana usulelo kunina ngaphambi okanye ngexesha lokubeleka. Olu lulandelayo lonyusa umngcipheko wosana lwe-sepsis yokuqala yebhaktiriya:

• I-GBS colonization ngexesha lokukhulelwa
• Ukuhanjiswa kwangaphambi kwexesha
• Ukophuka kwamanzi (ukuqhekeka kweembumba) ngaphezulu kweeyure ezili-18 ngaphambi kokuzalwa
• Usulelo lwee-placenta tissue kunye ne-amniotic fluid (chorioamnionitis)

Iintsana ezine-sepsis ezisekuhambeni kwexesha zisulelwa emva kokubeleka. Olu lulandelayo lonyusa umngcipheko wosana kwi-sepsis emva kokubeleka:

• Ukuba ne-catheter kwisitya segazi ixesha elide
• Ukuhlala esibhedlele ixesha elide

Iintsana ezine-sepsis engekazalwa zinganezi mpawu zilandelayo:

• Utshintsho lobushushu emzimbeni
• Iingxaki zokuphefumla
• Urhudo okanye ukuncipha kokuhamba kwamathumbu
• Iswekile esezantsi yegazi
• Ukuncipha kokuhamba
• Ukunciphisa ukuncancisa
• Ukuxhuzula
• Ukucotha okanye ukukhawuleza kwentliziyo
• Indawo yesisu edumbileyo
• Ukuhlanza
• Isikhumba esimthubi kunye namhlophe ngamehlo (jaundice)

Uvavanyo lweLebhu lunokunceda ukufumanisa isifo se-nepsatal sepsis kunye nokuchonga unobangela wosulelo. Uvavanyo lwegazi lunokubandakanya:

• Inkcubeko yegazi
• Iprotheyini esebenzayo yeC
• Gcwalisa ubalo lwegazi (CBC)

Ukuba umntwana uneempawu ze-sepsis, i-lumbar puncture (impompo yomqolo) iya kwenziwa ukujonga ulwelo lomqolo kwiibhaktheriya. Ulusu, isitulo, kunye neenkcubeko zomchamo zingenziwa kwintsholongwane ye-herpes, ngakumbi ukuba umama unembali yosulelo.

IX-ray yesifuba iyakwenziwa ukuba umntwana ukhohlela okanye uneengxaki zokuphefumla.

Iimvavanyo zenkcubeko yomchamo zenziwa kwiintsana ezindala kuneentsuku ezimbalwa.

Iintsana ezingaphantsi kweeveki ezi-4 ubudala ezinomkhuhlane okanye ezinye iimpawu zosulelo ziqala kwi-intravenous (IV) antibiotics ngokukhawuleza. (Kungathatha iiyure ezingama-24 ukuya kwezingama-72 ukufumana iziphumo zebhabhu.) Iintsana ezinomama abane-chorioamnionitis okanye abanokuba semngciphekweni omkhulu wezinye izizathu baya kufumana ii-antibiotics ze-IV ekuqaleni, nokuba abanazo iimpawu.

Usana luya kufumana i-antibiotics ukuya kwiiveki ezi-3 ukuba ibhaktheriya ifunyenwe egazini okanye kumqolo womqolo. Unyango luya kufutshane ukuba akukho bhaktheriya.

Iyeza le-antiviral elibizwa ngokuba yi-acyclovir liyakusetyenziselwa usulelo olunokubangelwa yi-HSV. Iintsana ezindala ezineziphumo eziqhelekileyo zeelebhu kwaye ezinomkhuhlane kuphela azinakunikwa zintsholongwane. Endaweni yoko, umntwana angakwazi ukuphuma esibhedlele aze abuye ukuze ahlolwe.

Iintsana ezifuna unyango kwaye esele zigodukile emva kokuzalwa ziya kuhlala zingeniswa esibhedlele ukuze zihlolwe.

Uninzi lweentsana ezinosulelo lwebacteria luya kuphila ngokupheleleyo kwaye alunazo ezinye iingxaki. Nangona kunjalo, isifo se-neonatal sepsis sesona sizathu siphambili sokufa kweentsana. Ngokukhawuleza xa usana lufumana unyango, kokukhona umphumo uba bhetele.

Iingxaki zinokubandakanya:

• Ukukhubazeka
• Ukufa

Funa uncedo lwezonyango kwangoko kusana olubonisa iimpawu ze-nepsatal sepsis.

Abafazi abakhulelweyo banokufuna i-antibiotics yokuthintela ukuba:

• Chorioamnionitis
• Ukusasazwa kweqela B kwiqela
• Ukunikezelwa ngexesha elidlulileyo kusana olune-sepsis olubangelwa ziintsholongwane

Ezinye izinto ezinokunceda ukukhusela i-sepsis zibandakanya:

• Ukuthintela nokunyanga usulelo koomama, kubandakanya iHSV
• Ukubonelela ngendawo ecocekileyo yokuzalwa
• Ukuhambisa umntwana kwisithuba seeyure ezili-12 ukuya kwezi-24 xa inwebu iqhawuka (ukuhanjiswa kweKesareya kufuneka kwenziwe kwabasetyhini kwisithuba seeyure ezi-4 ukuya kwezi-6 okanye kungekudala kuqhekezwe inwebu.)

Sepsis neonatorum; Ukubeleka kwangaphambi kokubeleka Sepsis - usana

Ikomiti yezifo ezosulelayo, iKomiti engemveku engekazalwa kunye neentsana; U-Baker CJ, uByington CL, uPolin RA. Isiteyitimenti somgaqo-nkqubo-izindululo zokuthintela isifo se-B septptococcal (GBS). IPediatrics. Ngo-2011; 128 (3): 611-616. IINKCUKACHA: 21807694 www.ncbi.nlm.nih.gov/pubmed/21807694.

Usulelo lwebhakteria lwasemva kokubeleka. KuMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 48.

IGreenberg JM, uHaberman B, uNarendran V, uNatan AT, uSchibler K.Izifo ezibangelwa kukuzalwa komntwana ngaphambi kokuzalwa kunye nemvelaphi yangaphambi kokubeleka. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Isilivere RM, ii-eds. I-Creasy kunye neResnik's Maternal-Fetal Medicine: Imigaqo kunye nokuziqhelanisa. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

UJaganath D, ngokufanayo RG. Microbiology kunye nezifo ezosulelayo. Ku: Isibhedlele saseJohn Hopkins; IHughes HK, Kahl LK, ii-eds. Incwadi yesikhokelo seHarriet. Umhla wama-21. IPhiladelphia, PA: Elsevier; I-2018: isahluko 17.

UPolin R, uRandis TM. Usulelo lwe-Perinatal kunye ne-chorioamnionitis. KuMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 25.

UVerani JR, uMcGee L, uSchrag SJ; Ukwahlulwa kweZifo zeBacteria, iZiko leSizwe lokuGonya kunye nezifo zokuphefumla, Amaziko oLawulo lweZifo kunye noThintelo (CDC). Uthintelo lweqela langaphambi kokubeleka B isifo se-streptococcal-izikhokelo ezihlaziyiweyo ezivela kwi-CDC, 2010. Ingcebiso kaMMWR. 2010; 59 (RR-10): 1-36. IINKCUKACHA: 21088663 www.ncbi.nlm.nih.gov/pubmed/21088663.