All About Neonatal Sepsis

Neonatal sepsis is a blood infection (usually bacterial) occurring in infants less than 3 months old. It is a leading cause of morbidity and mortality among both term and preterm infants

Risk Factors of neonatal sepsis

  1. Low birth weight infants

  2. Premature births

  3. Infants with low APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score

  4. Premature rupture of membranes (longer than 18 hours before birth)

  5. Poor nutrition or substance abuse in the mother

  6. Infection of the placental tissues and amniotic fluid (chorioamnionitis)

Types of neonatal sepsis

  1. Early-onset: (0-3 days of life) The infection is acquired from the mother during: Pregnancy (passed through the placenta) Birth: From the birth canal or via the cervix due to premature rupture of membranes

  2. Late-onset: (after 4 days of life) The infection is acquired from the environment in the home or hospital

Symptoms of neonatal sepsis

Early signs of neonatal sepsis are often subtle and non-specific, due to which the site of infection cannot be identified by the symptoms.

Common symptoms include:

  1. Reduced activity or movements in the baby

  2. Apnea (an abnormal pause in breathing)

  3. Feeding difficulty

  4. Fever or hypothermia (below normal temperature)

  5. Respiratory distress

  6. Seizures

  7. Jaundice

  8. Vomiting

  9. Diarrhoea

Diagnosis of neonatal sepsis

Diagnosis is done using a combination of tests, decided according to the symptoms and history. The tests commonly performed are:

  1. Blood tests: To detect signs of infection, such as elevated levels of white blood cell count and C-reactive protein

  2. Blood culture tests: To identify bacteria causing the infection

  3. Cerebrospinal fluid (CSF) testing: To detect signs of bacterial infection

  4. Imaging studies: A chest X-ray for a lung infection (pneumonia). Other scans like CT or MRI to visualize other areas such as the brain

Treatment of neonatal sepsis

  1. Intravenous (IV) antibiotics or antivirals with continuous monitoring

  2. A radiant warmer or incubator for maintaining normal body temperature

Possible Complications of neonatal sepsis

If the baby is not given the required treatment to control infection, sepsis may cause complications such as disability or death

Prevention of neonatal sepsis

Pregnant women may require preventive antibiotics if they have-

  1. Chorioamnionitis (infection of the fetal membranes caused by bacteria)

  2. Group B strep colonization

  3. Given birth in the past to a baby with sepsis caused by bacteria

The following preventive measures also help prevent sepsis-

  1. Early treatment and prevention of infections in mother, including HSV (Herpes simplex virus)

  2. Delivering the baby within 12 hours of when the membrane breaks

  3. Providing a clean place of birth

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