Pūʻulu B streptococcal septicemia o ka hānau hou

ʻO ka Group B streptococcal (GBS) septicemia kahi maʻi bacteria i hōʻeha ʻia i nā pēpē hou.

He maʻi ʻo Septicemia i loko o ke kahena e holo paha i nā kino like ʻole o ke kino. Hoʻokumu ʻia ka GBS septicemia e ka maʻi bacteria Streptococcus agalactiae, ka mea i kapa mau ʻia ʻo ka hui B strep, a i ʻole GBS.

ʻIke ʻia ʻo GBS i nā mākua a me nā keiki nui, a ʻaʻole maʻamau ka maʻi. Akā hiki iā ia ke maʻi i nā pēpē hou. ʻElua ala e hiki ai ke hāʻawi ʻia i GBS i kahi pēpē hou:

• Hiki i ke pēpē ke lilo i maʻi i ka wā e hele ana i loko o ke kahawai hānau. I kēia hihia, maʻi nā pēpē ma waena o ka hānau a me 6 mau lā o ke ola (pinepine i nā hola 24 mua). Kāhea ʻia kēia ka maʻi GBS hoʻomaka mua.
• Pilikia paha ke pēpē ma hope o ka hānau ʻana ma o ka launa ʻana me nā poʻe e hāpai ana i ka germ GBS. I kēia hihia, ʻike ʻia nā ʻōuli ma hope, ke 7 mau lā o ke pēpē a 3 mau mahina a ʻoi paha. Kapa ʻia kēia maʻi GBS lohi.

ʻOi aku ka pinepine o ka septicemia GBS, no ka mea aia kekahi mau ʻano e pale a mālama i nā wahine hāpai i ka makaʻu.

Hoʻonui ka mea aʻe i ka makaʻu o kahi pēpē no ka GBS septicemia:

• Hānau ʻia ma mua o 3 mau pule ma mua o ka lā palena pau (prematurity), keu hoʻi inā hele ka makuahine i ka hana mua (hana mua)
• ʻO ka makuahine i hānau mua i kahi pēpē me ka sepsis GBS
• ʻO ka makuahine i loaʻa i ke kuni o 100.4 ° F (38 ° C) a ʻoi aku paha i ka wā o ka hana
• ʻO ka makuahine i loaʻa ka pūʻulu B streptococcus i loko o kāna gastrointestinal, reproductive, a i ʻole urinary tract
• ʻO ka haki ʻana o nā membrane (haki ka wai) ma mua o 18 mau hola ma mua o ka hānau ʻia ʻana o ka pēpē
• Hoʻohana o ka nānā fetal intrauterine (kēpau poʻo poʻo) i ka wā o ka hana

Loaʻa paha i ka pēpē kekahi o nā hōʻailona a me nā ʻōuli:

• He ʻano hopohopo a koʻikoʻi paha
• ʻO ka helehelena polū (cyanosis)
• Nā pilikia hanu, e like me ka lapalapa ʻana o nā puka ihu, nā leo namunamu, ka hanu wikiwiki ʻana, a me nā wā pōkole me ka ʻole o ka hanu
• Palena ʻole o ka puʻuwai a me ke kaulike (wikiwiki a lohi paha)
• Lethargy
• ʻO ka helehelena pale (pallor) me ka ʻili anuanu
• ʻAi hānai maikaʻi ʻole
• Mahana wela o ke kino (haʻahaʻa a kiʻekiʻe paha)

No ke kuhi ʻana i ka septicemia GBS, pono e loaʻa ka bacteria GBS i kahi laʻana o ke koko (ka moʻomeheu koko) i lawe ʻia mai kahi keiki hānau maʻi.

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• Nā hoʻāʻo ʻana o ke kāpili koko - ka manawa prothrombin (PT) a me ka manawa thromboplastin hapa (PTT)
• Nā kinoea koko (e ʻike inā pono ke kōkua i ka pēpē me ka hanu ʻana)
• Helu piha koko
• ʻO ka moʻomeheu CSF (e nānā no ka meningitis)
• Moʻomeheu mimi
• X-ray o ka umauma

Hāʻawi ʻia ka pēpē i nā antibiotic ma o ke aa (IV).

Pili paha nā hana lapaʻau ʻē aʻe i:

• Kōkua hanu (kākoʻo hanu)
• Hāʻawi ʻia nā wai i loko o kahi aa
• ʻO nā lāʻau e hoʻohuli i ka haʻalulu
• Nā lāʻau lapaʻau a i ʻole nā ​​kaʻina hana e hoʻoponopono i nā pilikia pili koko
• ʻOkoʻa oxygen

ʻO kahi therapy i kapa ʻia ʻo oxygenac membrane extracorporeal (ECMO) e hoʻohana ʻia i nā hihia koʻikoʻi loa. Hoʻopili ʻo ECMO i ka hoʻohana ʻana i ka pauma e hoʻopolo i ke koko ma o ka pulupulu hana i hoʻi i loko o ke kahe o ke pēpē.

Hiki i kēia maʻi ke hoʻoweliweli i ke ola me ka ʻole o ka mālama koke.

ʻO nā pilikia i hiki ke hoʻopili ʻia:

• Hoʻomaʻamaʻa intravascular coagulation (DIC): He maʻi koʻikoʻi i kahi e hana maʻamau ai nā protein i kaohi ʻana i ke kāpili ʻana o ke koko.
• Hypoglycemia, a i ʻole ke kō kō.
• Meningitis: Ka pehu ʻana (mumū) o nā membrane e uhi ana i ka lolo a me ka iwi kuamoʻo i hoʻokumu ʻia e ka maʻi.

ʻIke pinepine ʻia kēia maʻi ma hope koke iho o ka hānau ʻana, ʻoiai pinepine ka pēpē i ka haukapila.

Eia nō naʻe, inā he keiki hānau hou kāu ma ka home e hōʻike ana i nā ʻōuli o kēia ʻano, e ʻimi koke i ke kōkua olakino pilikia a kāhea paha i ka helu pilikia kūloko (e like me 911)

Pono nā mākua e nānā i nā ʻōuli ma kā lākou pēpē i nā 6 pule mua. Hiki i nā pae mua o kēia maʻi ke hana i nā ʻōuli paʻakikī e ʻike.

I mea e hōʻemi ai i ka makaʻu no GBS, pono e hoʻāʻo nā wahine hāpai no ka maʻi bacteria ma 35 a 37 mau pule i ko lākou hāpai ʻana. Inā ʻike ʻia ka maʻi koʻohune, hāʻawi ʻia nā wahine i nā antibiotic ma o ke aa i ka wā o ka hana. Inā hele ka makuahine i ka hana maʻamau ma mua o 37 mau pule a loaʻa ʻole nā ​​hopena hōʻike GBS, pono ʻo ia e mālama ʻia me nā lāʻau ʻaloʻalo.

ʻO nā keiki hānau hou i ka makaʻu nui e hoʻāʻo ʻia no ka maʻi GBS. Hiki iā lākou ke loaʻa nā lāʻau ʻalopika ma o kahi aa i loko o ka 30 mua a 48 mau hola o ke ola a hiki i ka loaʻa ʻana o nā hopena hōʻike. ʻAʻole pono lākou e hoʻouna ʻia i ka home mai ka haukapila ma mua o 48 mau makahiki.

I nā hihia āpau, hiki i ka holoi lima kūpono ʻana e nā kahu hānai, nā mea kipa, a me nā mākua ke kōkua i ka pale ʻana i ka pāhola ʻana o ka bacteria ma hope o ka hānau ʻia ʻana o ka pēpē.

Hiki i ke kuhi mua ke kōkua i ka hōʻemi ʻana i ka pilikia no kekahi mau pilikia.

Pūʻulu B strep; GBS; Sepsis neonatal; Sepsis neonatal - strep

Nā kikowaena no ka pūnaewele Disease Control a me Prevent. Pūʻulu B strep (GBS). www.cdc.gov/groupbstrep/clinicians/clinical-overview.html. Hoʻohou i Mei 29, 2018. Loaʻa iā Kēkēmapa 10, 2018.

ʻO Edwards MS, Nizet V, Baker CJ. Nā maʻi maʻi streptococcal B. I: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, hua. ʻO nā maʻi maʻi Remington a me Klein o ka Fetus a me ke keiki hānau. 8th ed. Piladelapia, PA: Elsevier Saunders; 2016: chap 12.

Lachenauer CS, Wessels MR. Pūʻulu B streptococcus. I: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 20 ouk. Piladelapia, PA: Elsevier; 2016: chap 184.