Case 1: The patient was a 3 1/2 week-old male who was born at term. He required intubation at that time and continued to require respiratory support. Over a 24-hour period, the infant developed bulging anterior fontanelles (the “soft spots” in the skull), increased respiratory and heart rates, wide fluctuations in blood pressure, and difficulties maintianing adequate tissue perfusion, and his peripheral white blood cell count increased from 6,300 to 13,700/ml. The child began to have focal seizures as well. A cerebrospinal fluid (CSF) examination showed 3,900 WBC/ml (increase) with 92% neutrophils, glucose 2 mg/dl (decrease), and protein of 350 mg/dl (increase). Gram staining of the child’s CSF showed a gram-positive coccus. Case Study 1 Question 4: Which strategy would be most successful for prevention of neonatal infections with this organism?
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