{"id":10824,"date":"2023-08-02T23:44:16","date_gmt":"2023-08-02T15:44:16","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&#038;p=10824"},"modified":"2025-02-11T13:36:19","modified_gmt":"2025-02-11T05:36:19","slug":"soc-nhiem-khuan-khoi-phat-som-o-tre-so-sinh","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/soc-nhiem-khuan-khoi-phat-som-o-tre-so-sinh\/","title":{"rendered":"S\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh"},"content":{"rendered":"\n<p><strong>M\u1ede \u0110\u1ea6U<\/strong><\/p>\n\n\n\n<p>S\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh, \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n trong v\u00f2ng 28 ng\u00e0y \u0111\u1ea7u \u0111\u1eddi. T\u1ef7 l\u1ec7 t\u1eed vong do s\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 11 \u2013 19%. S\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm (EOS), x\u1ea3y ra trong v\u00f2ng 7 ng\u00e0y \u0111\u1ea7u \u0111\u1eddi v\u00e0 nh\u00f3m s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t mu\u1ed9n (LOS), x\u1ea3y ra sau khi tr\u1ebb \u0111\u01b0\u1ee3c 7 ng\u00e0y tu\u1ed5i. T\u1ef7 l\u1ec7 t\u1eed vong c\u1ee7a s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm l\u00e0 3%.<\/p>\n\n\n\n<p><strong>Y\u1ebeU T\u1ed0 NGUY C\u01a0<\/strong><\/p>\n\n\n\n<p>Y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ecb s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh bao g\u1ed3m:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ng\u01b0\u1eddi m\u1eb9 nhi\u1ec5m&nbsp;<em>Streptococcus&nbsp;<\/em>nh\u00f3m B<em>&nbsp;<\/em>m\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7y \u0111\u1ee7<\/li>\n\n\n\n<li>Nhi\u1ec5m tr\u00f9ng m\u00e0ng \u1ed1i<\/li>\n\n\n\n<li>Th\u00e2n nhi\u1ec7t c\u1ee7a ng\u01b0\u1eddi m\u1eb9 &gt; 38\u25e6C<\/li>\n\n\n\n<li>V\u1ee1 m\u00e0ng \u1ed1i &gt; 18 gi\u1edd<\/li>\n\n\n\n<li>Sinh non<\/li>\n<\/ul>\n\n\n\n<p><strong>VI SINH V\u1eacT G\u00c2Y S\u1ed0C NHI\u1ec4M KHU\u1ea8N KH\u1edeI PH\u00c1T S\u1edaM TH\u01af\u1edcNG G\u1eb6P<\/strong><\/p>\n\n\n\n<p>M\u1ed9t s\u1ed1 vi sinh v\u1eadt g\u00e2y s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm th\u01b0\u1eddng g\u1eb7p \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong h\u00ecnh 1.<\/p>\n\n\n\n<p><img decoding=\"async\" alt=\"\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-5b6960d14a2a0545be7bafc7e4f18ce4.png\">H\u00ecnh 1. C\u00e1c vi sinh v\u1eadt g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p, c\u01a1 ch\u1ebf g\u00e2y b\u1ec7nh v\u00e0 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng \u1ee9ng<\/p>\n\n\n\n<p><strong><em>Streptococcus nh\u00f3m B&nbsp;<\/em><\/strong><strong><em>(GBS)<\/em><\/strong><\/p>\n\n\n\n<p>GBS, c\u00f2n \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfnl\u00e0&nbsp;<em>Streptococcus agalactiae,&nbsp;<\/em>l\u00e0 m\u1ed9t vi khu\u1ea9n gram d\u01b0\u01a1ng. Tr\u1ebb th\u01b0\u1eddng ph\u01a1i nhi\u1ec5m v\u1edbi GBS t\u1eeb \u0111\u01b0\u1eddng ni\u1ec7u c\u1ee7a ng\u01b0\u1eddi m\u1eb9. Nguy c\u01a1 nhi\u1ec5m GBS ph\u1ee5 thu\u1ed9c v\u00e0o m\u1eadt \u0111\u1ed9 c\u1ee7a GBS c\u1ee7a ng\u01b0\u1eddi m\u1eb9. Nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t nh\u1edd d\u1ef1 ph\u00f2ng (intrapartum prophylaxis), do v\u1eady, l\u00e0m gi\u1ea3m nguy c\u01a1 l\u00e2y nhi\u1ec5m cho tr\u1ebb s\u01a1 sinh. S\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do GBS th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n trong v\u00f2ng 24 gi\u1edd sau sinh \u1edf 85% tr\u01b0\u1eddng h\u1ee3p. Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng th\u01b0\u1eddng g\u1eb7p l\u00e0 suy h\u00f4 h\u1ea5p, kh\u00f3 th\u1edf, vi\u00eam ph\u1ed5i. Trong khi \u0111\u00f3, s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t mu\u1ed9n do GBS th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 vi\u00eam m\u00e0ng n\u00e3o. N\u1ebfu tr\u1ebb \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh s\u1ed1c nhi\u1ec5m khu\u1ea9n do GBS, n\u00ean kh\u1edfi ph\u00e1t \u0111i\u1ec1u tr\u1ecb v\u1edbi penicillin v\u00e0 aminoglycosides.<\/p>\n\n\n\n<p><strong><em>Escherichia coli<\/em><\/strong><\/p>\n\n\n\n<p>M\u1eb7c d\u00f9&nbsp;<em>E. coli<\/em>&nbsp;l\u00e0 vi khu\u1ea9n gram \u00e2m, th\u01b0\u1eddng khu tr\u00fa \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a d\u01b0\u1edbi, nh\u0169 nhi v\u1eabn c\u00f3 th\u1ec3 b\u1ecb ph\u01a1i nhi\u1ec5m v\u1edbi&nbsp;<em>E. coli<\/em>&nbsp;trong qu\u00e1 tr\u00ecnh sinh n\u1edf v\u00ec \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o c\u0169ng th\u01b0\u1eddng c\u00f3&nbsp;<em>E. coli&nbsp;<\/em>khu tr\u00fa. M\u1ed9t s\u1ed1 bi\u1ec3u hi\u1ec7n nhi\u1ec5m khu\u1ea9n bao g\u1ed3m: th\u00e2n nhi\u1ec7t kh\u00f4ng \u1ed5n \u0111\u1ecbnh, suy h\u00f4 h\u1ea5p, kh\u00f3 th\u1edf, ng\u1ee7 l\u1ecbm v\u00e0 jaundice. KI capsular antigen l\u00e0 t\u00e1c nh\u00e2n th\u01b0\u1eddng g\u1eb7p d\u1eabn \u0111\u1ebfn nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 vi\u00eam m\u00e0ng n\u00e3o \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do&nbsp;<em>E. coli.&nbsp;<\/em>Nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do&nbsp;<em>E. coli<\/em>&nbsp;\u0111\u1ec1 kh\u00e1ng ampicillin nh\u01b0ng nh\u1ea1y v\u1edbi gentamicin. Do v\u1eady, \u1edf nh\u1eefng \u0111\u1ecba ph\u01b0\u01a1ng c\u00f3 t\u1ef7 l\u1ec7 \u0111\u1ec1 kh\u00e1ng ampicillin c\u00f2n th\u1ea5p, li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u tay l\u00e0 ampicillin v\u00e0 gentamicin. Nh\u01b0ng \u0111\u1ed1i v\u1edbi nh\u1eefng \u0111\u1ecba ph\u01b0\u01a1ng c\u00f3 t\u1ef7 l\u1ec7 \u0111\u1ec1 kh\u00e1ng ampicillin cao, carbapenem n\u00ean l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc.<\/p>\n\n\n\n<p><strong><em>Viridans Streptococci<\/em><\/strong><\/p>\n\n\n\n<p>M\u1eb7c d\u00f9 nh\u0169 nhi nhi\u1ec5m viridans Streptococci trong qu\u00e1 tr\u00ecnh sinh v\u00e0 bi\u1ec3u hi\u1ec7n b\u1ec7nh c\u0169ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do c\u00e1c t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh kh\u00e1c. Tuy nhi\u00ean, c\u00f3 t\u1edbi 26% tr\u01b0\u1eddng h\u1ee3p nh\u0169 nhi nhi\u1ec5m viridans Streptococci kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng. Do v\u1eady, k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u d\u01b0\u01a1ng t\u00ednh l\u00e0 m\u1ed9t ph\u1ea7n quan tr\u1ecdng v\u00e0 tr\u1ebb n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng aminoglycoside v\u00e0 beta-lactam ho\u1eb7c aminoglycoside v\u00e0 vancomycin (l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay).<\/p>\n\n\n\n<p><strong><em>Listeria monocytogenes<\/em><\/strong><\/p>\n\n\n\n<p>M\u1eb7c d\u00f9 s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do&nbsp;<em>Listeria&nbsp;<\/em>kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0 nh\u1eefng t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh kh\u00e1c, nh\u01b0ng t\u1ef7 l\u1ec7 t\u1eed vong l\u1ea1i r\u1ea5t cao (56%). S\u1ef1 l\u00e2y nhi\u1ec5m th\u01b0\u1eddng x\u1ea3y ra do th\u1ef1c ph\u1ea9m b\u1ecb nhi\u1ec5m&nbsp;<em>Listeria<\/em>&nbsp;\u0111\u01b0\u1ee3c m\u1eb9 ti\u00eau th\u1ee5. Nh\u0169 nhi b\u1ecb nhi\u1ec5m ho\u1eb7c qua nhau thai ho\u1eb7c qua n\u01b0\u1edbc \u1ed1i. \u0110a s\u1ed1 nh\u1eefng ng\u01b0\u1eddi m\u1eb9 c\u00f3 con b\u1ecb s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do nhi\u1ec5m&nbsp;<em>Listeria<\/em>&nbsp;th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n gi\u1ea3 c\u00fam tr\u01b0\u1edbc khi sinh. \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm do&nbsp;<em>Listeria&nbsp;<\/em>bao g\u1ed3m n\u01b0\u1edbc \u1ed1i nhu\u1ed9m ph\u00e2n su, kh\u00f3 th\u1edf, suy h\u00f4 h\u1ea5p v\u00e0 granulomatosis infantisepticum. Bi\u1ec3u hi\u1ec7n xu\u1ea5t hi\u1ec7n mu\u1ed9n h\u01a1n l\u00e0 h\u1ed3ng ban \u0111a d\u1ea1ng v\u1edbi nh\u1eefng n\u1ed1t s\u1ea9n b\u1ee3t m\u00e0u, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u1ea9n nghi\u00eam tr\u1ecdng. \u0110i\u1ec1u tr\u1ecb \u0111\u1ea7u tay l\u00e0 ampicillin v\u00e0 gentamycin.<\/p>\n\n\n\n<p><strong><em>Coagulase-Negative Staphylococci<\/em><\/strong><\/p>\n\n\n\n<p>Vi sinh v\u1eadt g\u00e2y nhi\u1ec5m khu\u1ea9n tr\u00ean ng\u01b0\u1eddi th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a nh\u00f3m n\u00e0y l\u00e0&nbsp;<em>Staphylococcus epidermidis, Staphylococcus haemolyticus,&nbsp;<\/em>v\u00e0<em>&nbsp;Staphylococcus saprophyticus.&nbsp;<\/em>V\u1edbi nh\u1eefng nh\u0169 nhi b\u1ecb nhi\u1ec5m khu\u1ea9n trong 2 \u2013 4 ng\u00e0y tu\u1ed5i, k\u1ebft qu\u1ea3 c\u1ea5y m\u00e1u d\u01b0\u01a1ng t\u00ednh v\u1edbi nh\u1eefng t\u00e1c nh\u00e2n n\u00e0y th\u01b0\u1eddng l\u00e0 do m\u1eabu b\u1ec7nh ph\u1ea9m b\u1ecb t\u1ea1p nhi\u1ec5m. Tuy nhi\u00ean, k\u1ebft qu\u1ea3 n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0 d\u01b0\u01a1ng t\u00ednh th\u1eadt, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y th\u01b0\u1eddng b\u1ecb s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t mu\u1ed9n. T\u00ecnh tr\u1ea1ng n\u00e0y th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb thi\u1ebfu c\u00e2n khi sinh, sinh thi\u1ebfu th\u00e1ng v\u00e0 tr\u1ebb \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c \u1edf \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c t\u00edch c\u1ef1c d\u00e0nh cho tr\u1ebb s\u01a1 sinh. Coagulase-Negative Staphylococci c\u00f3 kh\u1ea3 n\u0103ng khu tr\u00fa \u1edf c\u00e1c b\u1ec1 m\u1eb7t c\u1ee7a c\u00e1c v\u1eadt ch\u1ea5t b\u1eb1ng nh\u1ef1a, vi\u1ec7c \u0111\u1eb7t catheter c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m coagulase-Negative Staphylococci \u1edf tr\u1ebb. Bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a s\u1ed1c nhi\u1ec5m khu\u1ea9n do coagulase-Negative Staphylococci l\u00e0 nhi\u1ec5m khu\u1ea9n huy\u1ebft. C\u00f3 h\u01a1n 90% lo\u00e0i coagulase-Negative Staphylococci kh\u00e1ng methicillin, do v\u1eady n\u00ean c\u00e2n nh\u1eafc vancomycin khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh.<\/p>\n\n\n\n<p><strong><em>Herpes Simplex Virus (HSV)<\/em><\/strong><\/p>\n\n\n\n<p>Nguy c\u01a1 nhi\u1ec5m HSV \u1edf tr\u1ebb cao nh\u1ea5t n\u1ebfu ng\u01b0\u1eddi m\u1eb9 b\u1ecb nhi\u1ec5m HSV nguy\u00ean ph\u00e1t \u1edf \u0111\u01b0\u1eddng ni\u1ec7u d\u1ee5c. N\u1eef gi\u1edbi c\u00f3 ti\u1ec1n s\u1eed nhi\u1ec5m herpes sinh d\u1ee5c n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng li\u1ec7u ph\u00e1p kh\u00e1ng virus v\u00e0o tu\u1ea7n thai th\u1ee9 36 \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 l\u00e2y nhi\u1ec5m cho tr\u1ebb. Tuy nhi\u00ean, k\u1ec3 c\u1ea3 khi ng\u01b0\u1eddi m\u1eb9 kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed nhi\u1ec5m HSV c\u0169ng kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c nguy c\u01a1 nhi\u1ec5m HSV \u1edf tr\u1ebb. Nhi\u1ec5m HSV \u1edf tr\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n qua nhi\u1ec5m tr\u00f9ng lan t\u1ecfa (25%), nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (30%) v\u00e0 nhi\u1ec5m tr\u00f9ng \u1edf da, m\u1eaft v\u00e0\/ho\u1eb7c mi\u1ec7ng (45%). Tri\u1ec7u ch\u1ee9ng nhi\u1ec5m HSV th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb l\u00e0 s\u1ed1t, n\u1ed5i m\u1ee5n n\u01b0\u1edbc v\u00e0 \u0111\u1ed9ng kinh. \u0110\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng nhi\u1ec5m HSV, n\u00ean thu th\u1eadp m\u1eabu ph\u1ebft b\u1ec1 m\u1eb7t, d\u1ecbch n\u00e3o t\u1ee7y v\u00e0 m\u1eabu m\u00e1u \u0111\u1ec3 l\u00e0m PCR. Acyclovir l\u00e0 l\u1ef1a ch\u1ecdn ph\u00f9 h\u1ee3p \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m HSV \u1edf tr\u1ebb s\u01a1 sinh.<\/p>\n\n\n\n<p><strong><em>Enterovirus<\/em><\/strong><\/p>\n\n\n\n<p>Nhi\u1ec5m enterovirus th\u01b0\u1eddng c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n kh\u1edfi ph\u00e1t nh\u01b0 kh\u00f3 ch\u1ecbu, bi\u1ebfng \u0103n, s\u1ed1t, ng\u1ee7 l\u1ecbm, suy h\u00f4 h\u1ea5p th\u01b0\u1eddng hi\u1ebfm g\u1eb7p. Ch\u1ea9n \u0111o\u00e1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh b\u1eb1ng test PCR v\u1edbi m\u1eabu b\u1ec7nh ph\u1ea9m thu \u0111\u01b0\u1ee3c t\u1eeb \u0111\u01b0\u1eddng m\u0169i-h\u1ea7u, ph\u00e2n, m\u00e1u, n\u01b0\u1edbc ti\u1ec3u ho\u1eb7c d\u1ecbch n\u00e3o t\u1ee7y. M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c tr\u01b0ng cho s\u1ed1c nhi\u1ec5m khu\u1ea9n do enterovirus, immunoglobulin \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p.<\/p>\n\n\n\n<p><strong><em>COVID-19<\/em><\/strong><\/p>\n\n\n\n<p>\u0110a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m COVID-19 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o th\u01b0\u1eddng x\u1ea3y ra \u1edf tr\u1ebb &gt; 7 ng\u00e0y tu\u1ed5i. V\u00ec ch\u01b0a c\u00f3 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c ch\u1ea5p thu\u1eadn cho nh\u0169 nhi nhi\u1ec5m COVID-19, n\u00ean ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb. &nbsp;<\/p>\n\n\n\n<p><strong>KI\u1ec2M SO\u00c1T<\/strong><\/p>\n\n\n\n<p>Khi \u0111\u00e1nh gi\u00e1 tr\u1ebb s\u01a1 sinh b\u1ecb s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm, m\u1ed9t s\u1ed1 t\u00e1c nh\u00e2n c\u1ee7a ng\u01b0\u1eddi m\u1eb9 n\u00ean \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 cho tr\u1ebb s\u01a1 sinh, ch\u1eb3ng h\u1ea1n nh\u01b0 nhi\u1ec5m GBS, nhi\u1ec5m tr\u00f9ng m\u00e0ng \u1ed1i, th\u1eddi gian v\u1ee1 m\u00e0ng \u1ed1i k\u00e9o d\u00e0i v\u00e0 sinh non. \u0110i\u1ec1u tr\u1ecb nhi\u1ec5m tr\u00f9ng m\u00e0ng \u1ed1i nhanh ch\u00f3ng v\u00e0 kh\u00e1ng sinh d\u1ef1 ph\u00f2ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 l\u00e2y nhi\u1ec5m cho tr\u1ebb s\u01a1 sinh. Bi\u1ec3u hi\u1ec7n c\u1ee7a tr\u1ebb s\u01a1 sinh khi ch\u00e0o \u0111\u1eddi v\u00e0 nh\u1eefng ti\u1ebfn tri\u1ec3n trong 12 \u2013 24 gi\u1edd k\u1ebf ti\u1ebfp l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 d\u1ef1 \u0111o\u00e1n cho t\u00ecnh tr\u1ea1ng s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm. C\u00e1c bi\u1ec3u hi\u1ec7n nh\u01b0 t\u0103ng nh\u1ecbp th\u1edf, t\u0103ng nh\u1ecbp tim, th\u00e2n nhi\u1ec7t kh\u00f4ng \u1ed5n \u0111\u1ecbnh, suy h\u00f4 h\u1ea5p v\u00e0 nhu c\u1ea7u \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p \u0111\u1ec1u l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u cho th\u1ea5y nguy c\u01a1 nhi\u1ec5m tr\u00f9ng.<\/p>\n\n\n\n<p>Nhi\u1ec1u c\u00e1ch ti\u1ebfp c\u1eadn kh\u00e1c nhau \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra \u0111\u1ec3 quy\u1ebft \u0111\u1ecbnh li\u1ec7u c\u1ea5y m\u00e1u ho\u1eb7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh kinh nghi\u1ec7m c\u00f3 c\u1ea7n thi\u1ebft. C\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb theo chi\u1ebfn l\u01b0\u1ee3c tr\u00ec ho\u00e3n \u0111i\u1ec1u tr\u1ecb \u1edf nh\u1eefng tr\u1ebb kh\u00f4ng bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u00f3 m\u1eb9 b\u1ecb nhi\u1ec5m tr\u00f9ng m\u00e0ng \u1ed1i, th\u0103m kh\u00e1m l\u00e2m s\u00e0ng th\u01b0\u1eddng xuy\u00ean v\u00e0 ki\u1ec3m tra c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n trong 36 \u2013 48 gi\u1edd, ch\u1ec9 c\u1ea5y m\u00e1u v\u00e0 b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh n\u1ebfu tr\u1ea1ng th\u00e1i l\u00e2m s\u00e0ng c\u1ee7a tr\u1ebb b\u1eaft \u0111\u1ea7u thay \u0111\u1ed5i. Chi\u1ebfn l\u01b0\u1ee3c n\u00e0y c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 gi\u1ea3m thi\u1ec3u vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng sinh \u1edf tr\u1ebb s\u01a1 sinh.<\/p>\n\n\n\n<p>C\u00f4ng c\u1ee5 \u01b0\u1edbc t\u00ednh nguy c\u01a1 s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng (h\u00ecnh 2). C\u00f4ng c\u1ee5 n\u00e0y c\u00f3 th\u1ec3 truy c\u1eadp qua trang web:&nbsp;<a href=\"https:\/\/neonatalsepsiscalculator.kaiserpermanente.org\/\">https:\/\/neonatalsepsiscalculator.kaiserpermanente.org\/<\/a>&nbsp;C\u00f4ng c\u1ee5 n\u00e0y \u0111\u00e1nh gi\u00e1 y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a nh\u0169 nhi v\u00e0 c\u00e1c t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng, t\u1eeb \u0111\u00f3 \u0111\u01b0a ra m\u1ed9t s\u1ed1 khuy\u1ebfn c\u00e1o (ch\u1eb3ng h\u1ea1n nh\u01b0 x\u00e9t nghi\u1ec7m m\u00e1u, c\u1ea5y m\u00e1u, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng kh\u00e1ng sinh etc). S\u1eed d\u1ee5ng c\u00f4ng c\u1ee5 n\u00e0y c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m 66% tr\u01b0\u1eddng h\u1ee3p c\u1ea5y m\u00e1u v\u00e0 48% tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng kh\u00e1ng sinh kinh nghi\u1ec7m m\u00e0 kh\u00f4ng l\u00e0m t\u0103ng bi\u1ebfn c\u1ed1 s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm, bi\u1ebfn c\u1ed1 t\u1eed vong hay t\u00e1i nh\u1eadp vi\u1ec7n.<\/p>\n\n\n\n<p><img decoding=\"async\" alt=\"\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-57703f5b873b42b752fe48ed3def19b3.jpg\">H\u00ecnh 2. C\u00f4ng c\u1ee5 \u01b0\u1edbc t\u00ednh nguy c\u01a1 s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh<\/p>\n\n\n\n<p>N\u1ebfu kh\u00e1ng sinh \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb, th\u00ec t\u00e1c nh\u00e2n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 ampicillin v\u1edbi aminoglycoside. Acyclovir c\u0169ng n\u00ean \u0111\u01b0\u1ee3c b\u1ed5 sung n\u1ebfu nghi nhi\u1ec5m HSV.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><strong>NGU\u1ed2N<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Briggs-Steinberg C, Roth P. Early-Onset Sepsis in Newborns. Pediatr Rev. 2023 Jan 1;44(1):14-22. doi: 10.1542\/pir.2020-001164. PMID: 36587021.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>M\u1ede \u0110\u1ea6U S\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh, \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n trong v\u00f2ng 28 ng\u00e0y \u0111\u1ea7u \u0111\u1eddi. T\u1ef7 l\u1ec7 t\u1eed vong do s\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh l\u00e0 11 \u2013 19%. S\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb s\u01a1 sinh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh s\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/docquity.com\/vi\/articles\/soc-nhiem-khuan-khoi-phat-som-o-tre-so-sinh\/\"> <span class=\"screen-reader-text\">S\u1ed1c nhi\u1ec5m khu\u1ea9n kh\u1edfi ph\u00e1t s\u1edbm \u1edf tr\u1ebb s\u01a1 sinh<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":123,"featured_media":10825,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1440],"articles_languages":[1375],"articles_filters":[],"class_list":["post-10824","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/10824","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=10824"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/10824\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/10825"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=10824"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=10824"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=10824"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=10824"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=10824"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=10824"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}