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BSN 2Y2-3
Neonatal pneumonia is lung infection in a neonate. Onset may be within hours of birth and part
of a generalized sepsis syndrome or after 7 days and confined to the lungs. Signs may be limited
to respiratory distress or progress to shock and death. Diagnosis is by clinical and laboratory
evaluation for sepsis. Treatment is initial broad-spectrum antibiotics changed to organism-
specific drugs as soon as possible.
Pneumonia is the most common invasive bacterial infection after primary sepsis. Early-onset
pneumonia is part of generalized sepsis that first manifests at or within hours of birth. Late-onset
pneumonia usually occurs after 7 days of age, most commonly in neonatal ICUs among infants
who require prolonged endotracheal intubation because of lung disease (called healthcare-
associated pneumonia)
Etiology
Organisms are acquired from the maternal genital tract or the nursery. These organisms include
gram-positive cocci (eg, groups A and B streptococci, both methicillin-sensitive and methicillin-
resistant Staphylococcus aureus) and gram-negative bacilli (eg, Escherichia coli,
Klebsiella sp, Proteus sp). In infants who have received broad-spectrum antibiotics, many other
pathogens may be found, including Pseudomonas, Citrobacter, Bacillus, and Serratia. Viruses or
fungi cause some cases.
Predisposing Factors
Diagnostic Test
Evaluation includes chest x-ray, pulse oximetry, blood cultures, and Gram stain and culture of
tracheal aspirate.
New, persistent infiltrates should be visible on chest x-ray but may be difficult to recognize if the
infant has severe bronchopulmonary dysplasia.
Treatment