Contenidos aplicación eCBB

The hands constitute the main form of transmission of microorganisms during patient care. The skin is a possible reservoir for various microorganisms that can be transferred from one surface to another. The skin of the hands hosts two principal microorganism populations: those belonging to the resident microbiota and those belonging to transient microbiota. Transient microbiotas colonize the most superficial layer of the skin, which allows their mechanical removal by handwashing with water and soap, although they are eliminated more easily when an antiseptic solution is used.

Screening tests are required for the following conditions:
- Inborn errors of metabolism and heart diseases. The tests should be carried out with a dried blood spot sample (heel prick), within 24 to 36 hours of birth. The number and type of diseases that should be screened depends on the screening package offered in each country.
- Critical congenital heart disease. This should be tested with pulse oximetry within 24 hours of birth.
Neonates requiring supplementary oxygen should be screened after 24 hours of being clinically stable, in ambient air.

Screening tests evaluate different health conditions before newborns are discharged from the care center. These tests, or screenings, allow the diagnosis of neurometabolic or structural diseases, such as congenital heart defects or hip dislocation.

INFLUENZA
•Pregnant women are at increased risk of influenza illness and its complications; so are their infants.
•Influenza vaccines are effective in preventing infection and reducing illness severity in the mother and the newborn. Influenza vaccines have been used for decades and their safety has been well documented. Communication strategies that encourage influenza vaccination is of utmost importance in order to promote its application.

Tetanus is a life-threatening noncommunicable disease caused by a potent neurotoxin produced by the bacterium Clostridium tetani.
Neonatal tetanus can be prevented through vaccination of women before or during pregnancy, which protects the mother and the baby through a transfer of tetanus antibodies. Hygienic childbirth practices are also important to prevent neonatal and maternal tetanus (NNT).

Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), is a leading cause of human disease and death, particularly in developing countries.
Worldwide, TB is intimately linked to poverty, making the control of TB a matter of justice and human rights.
In some areas with a high burden of TB, existing strategies for TB control cannot keep pace with the rising number of cases of TB occurring in parallel with the HIV/AIDS pandemic.
Emerging mycobacterial drug resistance further complicates the situation.

If the mother is HIV positive, the newborn should first be tested for HIV: if the child tests negative for HIV at 5 weeks of birth, he/she can get vaccinated with BCG.
In the case of hepatitis B vaccine, whether the mother or the baby are positive for HIV, the newborn can safely receive this vaccine as soon as possible after birth.

Maternal and neonatal immunization refers to immunization prior to pregnancy, during pregnancy, and during the post-partum period that is intended to provide protection to both the mother and her child.
This is a critical concept, as neonates and premature infants are particularly vulnerable to infections with vaccine-preventable diseases. Additionally, their immature immune systems cannot mount protective immune responses to specific vaccine antigens until several weeks or months after birth. This creates a gap during which newborns are extremely vulnerable.

The following signs should be assessed during each postnatal care contact and the newborn should be referred for further evaluation if any of the signs is present:
- stopped feeding well
- history of convulsions
- fast breathing
- severe chest in-drawing
- no spontaneous movement
- temperature >37.5 or <35.5 °C
- jaundice in the first 24 hours of life, or yellow palms and soles at any age.
The family should be encouraged to seek health care early if they identify any of the above danger signs in-between postnatal care visits.
 

For all neonates it is recommended topical ocular prophylaxis for the prevention of gonococcal (Neisseria gonorrhoeae) and chlamydial (Chlamydia trachomatis) ophthalmia neonatorum.