Topic Resources Hospital-acquired infections in newborns are infections that develop after newborns have been admitted to the nursery. These infections do not come from the mother when the baby is in the womb and do not occur at delivery. These
infections can be caused by bacteria, viruses, or fungi. Symptoms vary but may include vomiting, fever, and a rash. The diagnosis is typically based on a physical examination. Various measures, such as handwashing, can help prevent spreading infections. Infections are treated based on the cause. Symptoms of infection in newborns tend to be nonspecific. For example, newborns may have vomiting or poor feeding, increased sleepiness or lethargy, fever or low temperature, fast breathing, rashes, diarrhea, or a swollen abdomen. Many infections acquired before birth can cause or be accompanied by various symptoms or abnormalities.
Hospital-acquired infection is suspected based on a doctor's examination. Doctors may then test blood, urine, and spinal fluid samples to determine where the infection is and which organism is causing it. General measures that hospital staff members use to help prevent hospital-acquired infections include the following:
To reduce the spread of infection during a disease outbreak in the hospital, doctors may apply antibiotic ointments to the newborn's umbilical cord, nostrils, and circumcision site. To reduce the spread of infection in special care nurseries such as NICUs, hospital staff members ensure there is sufficient space between newborns who are in incubators or warmers. They also are careful to meticulously clean and disinfect or sterilize equipment and use IVs and ventilators for as short a time as possible. Hospital staff members, parents, and caregivers can help prevent the spread of hospital-acquired infections by always thoroughly washing their hands with soap and water or with antibacterial hand sanitizer. While in the hospital, newborns are carefully monitored for any signs of infection.
Treatment of hospital-acquired infections depends on the specific organism causing the infection. CLICK HERE FOR THE PROFESSIONAL VERSION  Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. These infection prevention and control considerations are for healthcare facilities providing obstetric care for pregnant patients with suspected1 or confirmed coronavirus disease (COVID-19) in inpatient obstetric healthcare settings including obstetrical triage, labor and delivery, recovery and inpatient postpartum settings. This information is intended to aid hospitals and clinicians in applying broader CDC interim guidance on infection prevention and control for COVID-19. Since maternity and newborn care units vary in physical configuration, each facility should consider their appropriate space and staffing needs to prevent transmission of the virus that causes COVID-19. These considerations include appropriate isolation of pregnant patients who have suspected1 or confirmed COVID-19; basic and refresher training for all healthcare personnel on those units to include correct adherence to infection control practices and personal protective equipment (PPE) use and handling; and sufficient and appropriate PPE supplies positioned at all points of care. These considerations are based upon the limited evidence available to date about transmission of the virus that causes COVID-19. The approaches outlined below are intentionally cautious until additional data become available to refine recommendations for prevention of person-to-person transmission in inpatient obstetric care settings. Although the overall risks are low, pregnant and recently pregnant people are at an increased risk for severe illness from COVID-19 —including illness that results in ICU admission, mechanical ventilation, and death—compared with non-pregnant people. Additionally, pregnant people with COVID-19 are at increased risk of preterm birth and stillbirth and might be at increased risk for other pregnancy complications. DispositionPatients with COVID-19 can be discharged from the healthcare facility whenever clinically indicated. For more information, see Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings. Meeting criteria for discontinuation of Transmission-Based Precautions is not a prerequisite for discharge. Patients who are able to be discharged from the hospital but have not met criteria to discontinue isolation and wish to reduce the risk of transmission to their newborn may continue temporary separation at their place of residence (if feasible) until cleared to discontinue home isolation following either the symptom based strategy or testing based strategy. When temporary separation is being considered, its risks and benefits should be discussed by the mother and the healthcare team. Decisions about temporary separation should be made in accordance with the mother’s wishes. For more information, refer to guidance in the Discontinuation of Home Isolation for Persons with COVID-19. People who are caring for infants and young children may experience increased stress, feelings of isolation, or loneliness because of social distancing measures during the COVID-19 outbreak or related temporary separation. Postpartum depression symptoms may be worsened because of COVID-19 social distancing measures. Providers are encourage to share resources with patients about coping with stress during the COVID-19 pandemic. Footnote:1 For the purpose of obstetric care, a suspected COVID-19 case is someone who has symptoms of COVID-19, or has had a recent high risk contact (such as a family member at home with COVID-19) and does not have a negative test result (either because no test was done or because the test is still pending). Some facilities may choose to test all patients regardless of symptoms or known exposure as part of a universal testing protocol. Regardless of pending test results, pregnant individuals who are asymptomatic at the time of admission and have no history of high risk contact should not be considered to be suspected cases. |
In the labor and delivery unit, which is the best way to prevent the spread of infection?
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