0P-S4-1
Children’s Hospital Westmead and University of Sydney, Australia Maternal immunisation against tetanus prevents neonatal
tetanus. Maternal screening
for hepatitis B virus helps prevent vertical transmission. The incidence of neonatal HIV
infection can be reduced from 15-40% to less than 10% of babies born to
HIV-positive mothers by the use of anti-retroviral drugs, but universal HIV
screening is expensive and ethically sensitive. The incidence of early-onset neonatal Group B
Streptococcal (GBS) infection can be reduced by up to 75% by treating
colonised women with intravenous penicillin during delivery. The most effective methods to prevent late-onset (nosocomial)
neonatal infections are cheap and effective. Those methods proven to reduce late onset sepsis include: ·
Handwashing – the single most effective way to
reduce spread of virulent organisms. ·
Infection control – cohorting (isolation) of
babies infected or colonised with virulent organism, in addition to
improved handwashing, is proven (gloves and gowns are not). ·
Breast milk – reduces incidence and mortality of
neonatal sepsis and diarrhoea. ·
Early enteric feeding – reduces risk of catheter
–associated sepsis. ·
Oral nystatin – reduces incidence of fungal
infections ·
Responsible antibiotic use – broad-spectrum
antibiotics select for multi-resistant organisms, while use of
narrow-spectrum antibiotics reduces antibiotic resistance.
PREVENTION OF NEONATAL INFECTIONS
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