Sepsis is a bacterial infection of the blood.
Newborns with sepsis are lethargic, do not breastfeed well, and often have a low body temperature.
The diagnosis is based on symptoms and the presence of bacteria in the blood.
Most newborns who recover from sepsis have no long-term problems.
Treatment includes antibiotics, fluids given intravenously, and sometimes a ventilator to support breathing and drugs to support blood pressure.
Premature infants are at a much higher risk of early and late sepsis than are full-term infants because their immune system is immature. Premature newborns lack specific antibodies to certain bacteria, because these antibodies do not cross the placenta from the mother into the fetus''s blood until late in pregnancy.
Other risk factors and causes of sepsis vary depending on when it occurs, which may occur within the first few days of life (early-onset sepsis) or seven or more days after birth (late-onset sepsis).
early onset sepsis
Risk factors include
Early, long-term rupture of the fluid-filled membranes surrounding the fetus
Infection of the mother
Presence of group B streptococcus bacteria in the mother
The risk of sepsis increases if the fluid-filled membranes surrounding the fetus rupture more than 18 hours before delivery, or if the mother has an infection (particularly of the urinary tract or endometrium).
The most common types of bacteria that cause sepsis in newborns around the time of birth are Escherichia coli and GBS streptococcus, which are usually acquired while passing through the birth canal. GBS sepsis was usually the main cause of early-onset sepsis until a decade ago, until screening of all expecting mothers for GBS became a routine part of prior care. for childbirth. If the examination detects the presence of group B streptococcus bacteria, then the mother can use antibiotics while she is in labour. If the birth was vaginally, the newborn is given antibiotics directly.
late-onset sepsis
Important risk factors include
Long-term use of catheters in the arteries, veins, or both
Using a breathing tube ed through the nose or mouth (endotracheal tube) and attached to a ventilator to help support breathing
Long stay in hospital
Late-onset sepsis is more likely to be acquired from unwashed hands or the environment, and may be caused by various organisms.
Symptoms and diagnosis
Newborns with sepsis are lethargic, do not breastfeed well, and often have a low body temperature. Other symptoms may include shortness of breath (apnea), fever, pale skin, poor blood circulation in the skin with cold extremities, abdominal swelling, vomiting, diarrhea, seizures, nervousness, and jaundice. Diagnosis is based on what the newborn''s symptoms suggest and the results of a complete blood count test. A clear diagnosis is made when the germ is detected by culturing the newborn''s blood.
One of the most serious complications of sepsis is inflammation of the membranes surrounding the brain (meningitis). Newborns with meningitis may have very slow (lethargy), coma, convulsions, or protrusion of a soft spot between the bones of the skull (fontanelle). Doctors can diagnose meningitis by doing a spinal tap (lumbar puncture), examining the cerebrospinal fluid and culturing a sample of this fluid.
Diagnosis and treatment
Sepsis is the leading cause of death in premature newborns after the first week. Newborns who recover from sepsis should not have long-term problems, except for those with meningitis who may have developmental delays, cerebral palsy, seizures, or hearing loss.
While waiting for blood transplant results, doctors recommend intravenous antibiotics for newborns with suspected sepsis. Once the infecting organism is identified, the type of antibiotic can be modified. In addition to antibiotic treatment, other treatments, such as ventilators, intravenous fluids, and support for blood pressure and circulation, may be necessary.
