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September-October

September – October 2018 CME Questions Causes of presumed neonatal sepsis and neonatal jaundice

Neonatal sepsis in Asia

Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study Saha SK, et al. Lancet 2018; 392: 145–59

 Saha et al Aetiology of Neonatal Infection in South Asia Lancet 2018

ANISA is a large study which enrolled 84,971 mothers antenatally in Bangladesh, India, and Pakistan, and used community health-care workers to follow up neonates after birth, and identify “neonatal sepsis”. It is an important study, because there are few population-based studies of community-acquired newborn sepsis in Asia.

  • In the ANISA study what proportion of “neonatal sepsis” had a proven bacterial cause? 
  • What proportion of blood cultures were positive, and what were the common bacteria isolated?
  • What proportion of “neonatal sepsis” was proven to be caused by viruses, and what was the most common virus isolated?
  • Were standard treatment antibiotics effective?
  • What is the main message of the study, regarding the causes of “presumed neonatal sepsis”?

 

Neonatal jaundice

Neonatal hyperbilirubinaemia: a global perspective

Olusanya, et al. Lancet Child Adolesc Health 2018 http://dx.doi.org/10.1016/S2352-4642(18)30139-1

 Olusanya B Neonatal Jaundice Global perspective Lancet CAH 2018

A review of the epidemiology, causes, consequences and treatment of neonatal jaundice.

  • What proportion of newborns become jaundiced, and what proportion have clinically significant jaundice?
  • What level of bilirubin is visibly detectable?
  • Is a little bit of jaundice good for newborn babies? Explain.
  • What are the manifestations of bilirubin encephalopathy?
  • What are the risk factors for severe jaundice in the newborn period?
  • How does phototherapy work, and when should it be started?
  • What are the indications for exchange transfusion, how does it work, and what are the complications?
  • How can the complications of severe jaundice be prevented?

September – October 2018 CME Q&A Causes of presumed neonatal sepsis and neonatal jaundice