[Causes of and change in bacterial infections in newborn infants].
Despite all the progress made in modern neonatology the morbidity rate caused by bacterial infections has rather gone up than down. The reasons why premature and newborn infants have a greater disposition to bacterial infections have been largely explored; at the same time one must accept these infants to be increasingly vulnerable to infections, the vulnerability being the larger the greater the degree of immaturity is. Every 5th to 10th death of newborn infants is caused by infection. One will have to be constantly on the watch and acquire profound knowledge of channels of infection and the bacterial spectrum to be expected. Since the early beginnings of neonatology, some 60 years ago, a continuous change in bacterial spectra has been going on showing incredible regularity in crossing even borders and continents. With gram-positive cocci (A streptococci) prevailing at the beginning, there was a considerable increase in gram-negative enterobacteriaceae in the 60ies and 70ies, when neonatal intensive medicine was started. There were mainly nosocomial infections resulting from too generously administered antibiotics. Today, plasmacoagulase-negative staphylococci, for a long period thought not to be pathogenous, are the essential bacteria in nosocomial infections. On the whole, one usually has to do with infections vertically transmitted by the mother, especially to preterm infants. The greatest threat still comes from B streptococci since they will lead to pulmonary changes such as pneumonia and RDS. The development reported on is based on data from the literature and my own experience as well as on comprehensive results of the Neonatalerhebung of Lower Saxony and Bavaria.
von Stockhausen
H B
HB
Universitäts-Kinderklinik Würzburg.
D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control; D001431:Bacteriological Techniques; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control
Ursachen und Wandel bakterieller Infektionen bei Neugeborenen.