Obstetric, Perinatal and neonatal infections

Infections in pregnancy may cause
 spontaneous abortion.
 premature labour, still birth,
 perinatal
 congenital infection
Infections in early pregnancy
 TORCH
 Toxoplasma, Rubella,Cytomegalovirus, Herpes Simplex
 Other include Influenza, Mumps, Measles, Coxsakie A16 virus
 These infections either lead to abortions or congenital anomalies
Laboratory Diagnosis of Pregnancy Infections
 For diagnosis of TORCH
Samples Can be
 -Maternal Blood
 Fetal blood samples if available or tissues (post morteum)
 -Serological diagnosis by IgM for recent infections or raised IgG four folds within 10 days
 PCR
Perinatal and neonatal bacterial infections
PERINATAL INFECTIONS
 The organisms that can infect the infant during birth from the genital tract or perineum are similar to those already mentioned for later intra-uterine infection via the ascending route.
 Neisseria gonorrhoeae, Chlamydia trachomatis (TR1C) agent and herpes simplex type II
Diagnosis of Perinatal Infections
 Complete Microbiological Diagnosis according to site of infections in the infant
NEONATAL AND CONGENITAL INFECTIONS
 Early onset infections due to Lancefield group B streptococci and Gram-negative bacilli
 After 4 – 7 days of life, ‘late onset’ neonatal infections due to these organisms may appear. The source of the organisms in late onset infections need not necessarily be the maternal perineal or genital tract flora. The source may he the already infected neonates in a baby unit or the hands of hospital staff which transmit these infections from one neonate to the next.
 Occasionally moist contaminated equipment, such as baby incubators which are humidified or baby resuscitation equipment, is the source of infection in a common source outbreak due to Pseudomonas aeruginosa or other Gram-neg­ative bacilli. Late onset serious Lancefield group B streptococcal or Gram-negative infec­tion is often characterized by the development of meningitis.

 Congenital infections by TORCH can be diagnosed by specific IgM
 Diagnosis of Syphilis can be performed by speciic IgM
Laboratory Diagnosis of Perinatal Infections
 Investigations should include the taking of blood cultures, swabs of umbilicus, skin, eye or any septic site, faeces for culture.
 Microscopy and culture of urine and cerebrospinal fluid.
 When pus is present, a Gram—stain of this can frequently give a rapid indication of the likely causative group of organisms; predominant numerous Gram-positive cocci could suggest the possibility of a Lancefield group B haemolvtic streptococcus or Staphylococcus aureus infection.
 However, the results of microscopy and culture of skin sites are often difficult to interpret in practice since coloniza­tion of the neonatal skin by streptococci, staphylococci and Gram-negative bacilli is also common and difficult to distinguish in the lab­oratory from infection due to these same organisms.
Laboratory Diagnosis of Perinatal Infections
 Investigations should include the taking of blood cultures, swabs of umbilicus, skin, eye or any septic site, faeces for culture.
 Microscopy and culture of urine and cerebrospinal fluid.
 When pus is present, a Gram—stain of this can frequently give a rapid indication of the likely causative group of organisms; predominant numerous Gram-positive cocci could suggest the possibility of a Lancefield group B haemolvtic streptococcus or Staphylococcus aureus infection.
 However, the results of microscopy and culture of skin sites are often difficult to interpret in practice since coloniza­tion of the neonatal skin by streptococci, staphylococci and Gram-negative bacilli is also common and difficult to distinguish in the lab­oratory from infection due to these same organisms.

You need more details read
Contents
1-The use of the Clinical Microbiology laboratory
(General principles )
2-Basic Laboratory procedures for microbiological
Diagnosis
3- Classification & pathogenicity of Microbes
4-Basic Bacterial Culture and Identification
5-Identification of Gram-Positive Bacteria
6-Culture and Identification of Fastidious Bacteria
7-Identification of the Enterobacteriacae
8-TESTS FOR SUSCEPTIBILITY TO
9-ANTIMICROBIAL AGENTS
10-Bacterial Staining
11-Sampling for FUNGAL Infections and Culture
12-Laboratory Diagnosis of Viral Diseases
13-BLOOD CULTURE
14-UPPER RESPIRATORY INFECTIONS
15-Lower respiratory tract infections
16-Wound, skin and deep sepsis
17-Genital tract infections
18-Meningitis
18-Gastrointestinal infections
20-Urinary tract infections
21-Pyrexia of unknown origin
22-Children Specific Infections
23-Clinical Groupings for Fungal Infections
24-Obesteric, Perineatal and neonatal Infections
25-Hospital Acquired Infections
26-Opportunistic Infections
27-Sterilization
28-Hepatitis
29-AIDs 138-141
30-Anaerobic Infections
31-Zoonosis
32-Antimicrobials
33-Monitoring antimicrobials therapy
34-Biosafety and Biohazard
35-Microbiology Quality control
36- Skeletal Infections
37-Bacterial Skin Infections
References