Musoke R N
Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, Kenya.
East Afr Med J. 1997 Mar;74(3):147-50.
Review of the management of neonatal infections is done with the aim of guiding the clinician on appropriate therapy. Minimum investigations should include a white blood cell count including the L:T ratio and a blood culture. The bulk of infections at Kenyatta National Hospital newborn unit are caused by Klebsiela, Citrobacter and Staphylococcus aureus. During the 1990's considerable resistance to gentamicin has developed. Currently, cephalosporins chloramphenicol have the best sensitivity pattern. The diagnosis must be carefully verified at different stages of treatment to ensure that only those requiring antimicrobial therapy get it. Indiscriminate use is thus avoided. This in turn minimises development of antibiotic resistant organisms. Failure of response to antimicrobials sometimes means a non infectious cause of illness or poor supportive management. Continuous surveillance is recommended with emphasis on primary prevention of infection as well as cross infections.
对新生儿感染管理进行综述的目的是指导临床医生进行适当的治疗。最少的检查应包括白细胞计数（包括淋巴细胞与中性粒细胞比例）和血培养。肯雅塔国家医院新生儿病房的大部分感染是由克雷伯菌、柠檬酸杆菌和金黄色葡萄球菌引起的。在20世纪90年代，对庆大霉素产生了相当大的耐药性。目前，头孢菌素和氯霉素具有最佳的敏感性模式。在治疗的不同阶段必须仔细核实诊断，以确保只有那些需要抗菌治疗的患者才接受治疗。从而避免了滥用。这反过来又最大限度地减少了抗生素耐药菌的产生。对抗生素无反应有时意味着疾病的非感染性原因或支持治疗不佳。建议持续监测，重点是感染的一级预防以及交叉感染。
