**8. References**


[10] Sert A, Yazar A, Odabas D et al. An unusual cause of fever in a neonate: Influenza A (H1N1) virus pneumonia. Pediatr Pulmonol 2010; 45:734-736.

Neonatal Pneumonia 31

[26] IH Celik H, Oguz SS, Demirel G et al. Outcome of ventilator-associated pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa treated with aerosolized colistin in neonates: a retrospective study. Eur J Pediatr 2012; 171:311-

[27] Nakwan N, Wannaro J, Thongmak T et al. Safety in treatment of ventilator-associated pneumonia due to extensive drug-resistant acinetobacter baumannii with aerosolized

[28] Ozdemir R, Erdeve O, Dizdar EA et a. Clarithromycin in preventing bronchopulmonary dysplasia in ureaplasma urealyticum-positive preterm infants. Pediatrics 2011; 128:

[29] Ballard HO, Shook LA, Bernard P et al. Use of azithromycin for the prevention of bronchopulmonary dysplasia in preterm infants. Pediatr Pulmonol.2011; 46: 111-118 [30] Mabanta CG, Pryhuber GS, Weinberg GA at al. Erythromycin for the prevention of chronic lung disease in intubated preterm infants at risk for, or colonized with

[31] Herting E, Gefeller O, Land M, et al. Surfactant treatment of neonates with respiratory failure and group B streptococcal infection. Members of the Collaborative European

[32] Finer NN. Surfactant use for neonatal lung injury: beyond respiratory distress

[33] Tan K, Lai NM, Sharma A. Surfactant for bacterial pneumonia in late preterm and term infants. Cochrane Database of Systematic Reviews. 2012, Issue 2, Art.No.CD008155 [34] Reiterer F, Kuttnig-Haim M, Maurer U et al. Erfolgreiche Behandlung einer therapierefraktären Schocklunge bei einem Neugeborenen mit connatalen Varicellen

mittels Extracorporealer Membranoxygenierung. Klin Pädiatrie 1994; 206; 92-94. [35] Malhotra A, Hunt R.W, Doherty R.R. Streptococcus pneumoniae sepsis in the newborn.

[36] Verani JR, Schrag SJ. Group B streptococcal disease in infants: progression in prevention

[37] Garland JS. Strategies to prevent ventilator-associated pneumonia in neonates. Clinics

[38] Abadesso C, Almeida HI, Virella D et al. Use of palizumab to control an outbreak of syncytial respiratory virus in a neonatal intensive care unit. J Hosp Infect 2004; 58(1):38-1 [39] Graham PL. Simple strategies to reduce health care associated infections in the neonatal

[40] Kanmaz G, Erdeve O, Oguz SS et al. Influenza A (H1N1) virus pneumonia in newborns: experience of a referral level III neonatal intensive care unit in turkey. Pediatric

[41] O`Dempsey BP, McArdle T, Ceesay SJ et al. Immunization with pneumococcal

[42] Jasser-Nitsche H, Reiterer F, Kutschera J et al. Listerienpneumonie bei einem reifen

unit: line, tube, and hand hygiene. Clinics in Perinatology 2010: 37: 645-653

polysaccharides vaccine during pregnancy. Vaccine 1996; 14: 963-970

Neugeborenen. Monatszeitschr Kinderheilkunde 2009; Suppl 2: 217-218

colistin in neonates: A preliminary report. Pediatr Pulmonol 2011; 46: 60-66

uraplasma urealyticum. Cochrane Database Syst Rev.2003; 4(4): CD003744

Multicenter-Study Group. Pediatrics 2000; 106:957-964.

syndrome. Paediatr Resp.Rev.2004; 5: Suppl A: S289-97

Journal of Paediatrics Child Health 2010; 48: E79-E83

in Perinatology 2010: 37: 629-643

Pulmonol 2011; 46: 201-202

and continued challenges. Clin Perinatol 2010; 37:375-392

316

e1496-e1501


htpp:// www.cdc.go/ncidodo/hip/NNIS/members/pneumonia/final/Pneu


[26] IH Celik H, Oguz SS, Demirel G et al. Outcome of ventilator-associated pneumonia due to multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa treated with aerosolized colistin in neonates: a retrospective study. Eur J Pediatr 2012; 171:311- 316

30 Neonatal Bacterial Infection

460-462

1990;65:207-211

2009; 14:190-199

14: 283-299.

WHO, 2000.

pneumonia. Available at:

Geburtshilfliche Rundsch 1999; 39:191-194

Perinatol.2010; 30 (5): 359-362

Cochrane library 2004; Issue 4.

Perinatol 2010; 37: 547-563

William and Wilkins, 1989: 59-65

Medicine 2012; 25; 7; 992-994

[10] Sert A, Yazar A, Odabas D et al. An unusual cause of fever in a neonate: Influenza A

[11] Swischuk LE. Imaging of the newborn, infant and young child. 3rd edition. Baltimore:

[12] Costa S, Rocha G, Leito A, Guimaraes H. Transient tachypnea of the newborn and congenital pneumonia: a comparative study. Journal of Maternal-Fetal and Neonatal

[13] Reiterer F, Dornbusch HJ, Urlesberger B et al. Cytomegalovirus associated neonatal pneumonia and Wilson-Mikity-syndrome: a causal relationship ?. Eur Resp. J 1999; 13:

[14] Booth GR, Al-Hosni M, Ali A et al. The utility of tracheal aspirate cultures in the

[15] Sherman MP, Goetzman BW, Ahlfors ChE. Tracheal aspirates and its clinical correlates

[16] Webber S, Wilkinson AR, Lindsell D et al. Neonatal pneumonia, Arch Dis Child

[17] Centers for Disease Control and Prevention. Criteria for defining nosocomial

[18] Apisarnthanarek A, Holsmannn-Pazgal G, Hamvas A et al. Ventilator associated pneumonia in extremely preterm neonates in an neonatal intensive care unit:

[19] Waites KB, Schelonka RL,Xiao L et al. Congenital and opportunistic infections: Ureaplasma species and mycoplasma hominis. Seminars in Fetal & Neonatal Medicine

[20] Zotter H, Urlesberger B, Reiterer F et al. Ureaplasmapneumonien und Nachweis von ureaplasma urealyticum im Tubussekret bei Früh-und Neugeborenen. Gynäkol

[21] Moriokoa I, Fujibayashi H.Enoki E et al. Congenital pneumonia with sepsis caused by intrauterine infection of ureaplasma parvum in a term newborn: a first case report. J

[22] Speer Ch, Sweet D. Surfactant Replacement: present and future. In Bancalari E, Polin R. (eds). The newborn lung. Neonatology questions and controversies. 2nd edition 2012;

[23] Mtitimila EI, Cooke RW. Antibiotic regimes for suspected early neonatal sepsis. The

[24] World Health Organization. Management of the child with a serious infection or severe malnutrition: Guidelines for care at first referral level in developing countries. Geneva:

[25] Patel SJ, Saiman L. Antibiotic resistance in neonatal intensive care unit pathogens: mechanism, clinical impact, and prevention including antibiotic stewardship. Clin

in the diagnosis of congenital pneumonia. Pediatrics 1980: 65:2:258-263

htpp:// www.cdc.go/ncidodo/hip/NNIS/members/pneumonia/final/Pneu

characteristics, risk factors, and outcomes. Pediatrics. 2003; 112:1283-1289

(H1N1) virus pneumonia. Pediatr Pulmonol 2010; 45:734-736.

immediate neonatal period. J Perinatal 2009; 29(7): 493-496


[43] Posfay-Barbe KM, Eald E. Listeriosis. Seminars in Fetal & Neonatal Medicine 2009; 14: 228-223

**Chapter 3** 

© 2013 Kiechl-Kohlendorfer and Griesmaier, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is

© 2013 Kiechl-Kohlendorfer and Griesmaier, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

properly cited.

**Neonatal Osteomyelitis** 

Ursula Kiechl-Kohlendorfer and Elke Griesmaier

dependent on rapid diagnosis and immediate start of treatment.

Acute osteomyelitis, although a rare complication in neonates, is a diagnostic and therapeutic challenge. Due to their immature immune response neonates are more susceptible to osteomyelitis than are older children. Preterm infants are at high risk for osteomyelitis because of frequent blood drawing, invasive monitoring/procedures and intravenous drug administration [1,2]. Early diagnosis of neonatal osteomyelitis might be difficult because of the paucity of clinical signs and symptoms, but has to be included in the differential diagnosis when late-onset or prolonged neonatal sepsis is present, as outcome is

In Western countries the incidence of osteomyelitis and septic arthritis is 5-12 per 100.000 infants [3]. The overall incidence rate for bone and joint infections is 0.12 per 1000 live births and 0.67 per 1000 neonatal intensive care (NICU) admissions [4], with a mortality rate of 7.3% [5]. Some recent studies have reported an estimated incidence of 1-7 per 1000 hospital admissions for neonatal osteomyelitis [6,7]. In a review of more than 300 cases of neonatal osteomyelitis male infants are seen to predominate over females (1.6:1) and preterm infants to be at higher risk than term infants [8-10]. Risk factors for osteomyelitis and septic arthritis in preterm infants are mostly iatrogenic, including invasive procedures, intravenous or intra-arterial catheters, parenteral nutrition, ventilatory support, and bacteremia with nosocomial pathogens [11,12]. Two subgroups of neonates are affected: premature neonates with prolonged hospitalization

Neonatal osteomyelitis arises as a consequence of hematogenous spread of microorganisms, which is the most common route of infection. In preterm infants, neonatal osteomyelitis

and otherwise healthy newborns presenting within 2 to 4 weeks of discharge [13].

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/54320

**1. Introduction** 

**2. Epidemiology** 

**3. Microbiology** 


**Chapter 3** 
