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Rickham's Neonatal Surgery pp 363–367Cite as

Infections and Antibiotic Therapy in Surgical Newborn Infants

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Abstract

Colonisation of the gastro-intestinal tract of newborn infants starts immediately after birth and occurs within a few days. Initially, the type of delivery (passage through the birth canal versus caesarean section) and the type of diet (breast versus formula feeding) might affect the colonisation pattern. Nearly all full-term, formula-fed, vaginally delivered infants were colonised with anaerobic bacteria within 4–6 days. 61% harboured Bacteroides fragilis. In contrast, anaerobes were present in 59% and B. fragilis in only 9% of infants delivered by caesarean section, suggesting that significant contamination occurred during passage through the birth canal. Both prematurity and breast feeding reduced the likelihood of isolating anaerobic species. Enterococci were isolated from all neonates, Escherichia coli from 82.6%, anaerobic cocci from 52.2% and both streptococci and staphylococci from 34.8%. Colonisation of the small bowel occurs perorally. In newborn infants with congenital small bowel obstruction, a faecal-type flora is found immediately proximal to the site of obstruction, and the distal bowel remains sterile.

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Author information

Authors and Affiliations

  1. Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK

    Hendrik K. F. van Saene MD, PhD, FRCPath & Nia Taylor MPhil

  2. Radcliffe Department of Medicine, University of Oxford, Oxford, UK

    Shijie Cai MD, PhD, MPhil

  3. Department of Pharmacy, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK

    Nicola Reilly BSc

  4. Paediatric Intensive Care Unit, Great Ormond Street, London, UK

    Andy Petros MD, MSc, MA, FRCP

  5. Department of Paediatric Surgery, University Hospital of the North Midlands and Alder Hey Children’s Hospital, Liverpool, Merseyside, UK

    Stephen C. Donnell MB, ChB, FRCS(Paed)

Authors
  1. Hendrik K. F. van Saene MD, PhD, FRCPath
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  2. Nia Taylor MPhil
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  3. Shijie Cai MD, PhD, MPhil
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  4. Nicola Reilly BSc
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  5. Andy Petros MD, MSc, MA, FRCP
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  6. Stephen C. Donnell MB, ChB, FRCS(Paed)
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Corresponding author

Correspondence to Nia Taylor MPhil .

Editor information

Editors and Affiliations

  1. Division of Child Health, Alder Hey Children’s NHS Foundation Trust, Liverpool, United Kingdom

    Paul D. Losty

  2. University of Pennsylvania , Philadelphia, Pennsylvania, USA

    Alan W. Flake

  3. Childrens Hospital, University of Helsinki, Helsinki, Finland

    Risto J. Rintala

  4. Royal Children’s Hospital, University of Melbourne, Parkville, Victoria, Australia

    John M. Hutson

  5. Department of Surgery, Meiji University of Integrative Medicine, Kyoto, Japan

    Naomi lwai

Additional information

In memory of Shankar, his kindness, dedication and superb professionalism.

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van Saene, H.K.F., Taylor, N., Cai, S., Reilly, N., Petros, A., Donnell, S.C. (2018). Infections and Antibiotic Therapy in Surgical Newborn Infants. In: Losty, P., Flake, A., Rintala, R., Hutson, J., lwai, N. (eds) Rickham's Neonatal Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4721-3_13

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  • DOI: https://doi.org/10.1007/978-1-4471-4721-3_13

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4720-6

  • Online ISBN: 978-1-4471-4721-3

  • eBook Packages: MedicineMedicine (R0)

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