Condition 101 About Neonatal Sepsis

What is the definition of Neonatal Sepsis?

Neonatal sepsis is a blood infection that occurs in an infant younger than 90 days old. Early-onset sepsis is seen in the first week of life. Late onset sepsis occurs after 1 week through 3 months of age.

What are the alternative names for Neonatal Sepsis?

Sepsis neonatorum; Neonatal septicemia; Sepsis - infant

What are the causes for Neonatal Sepsis?

Neonatal sepsis can be caused by bacteria such as Escherichia coli (E coli), Listeria, and some strains of streptococcus. Group B streptococcus (GBS) has been a major cause of neonatal sepsis. However, this problem has become less common because women are screened during pregnancy. The herpes simplex virus (HSV) can also cause a severe infection in a newborn baby. This happens most often when the mother is newly infected.

Early-onset neonatal sepsis most often appears within 24 to 48 hours of birth. The baby gets the infection from the mother before or during delivery. The following increase an infant's risk of early-onset bacterial sepsis:

  • GBS colonization during pregnancy
  • Preterm delivery
  • Water breaking (rupture of membranes) longer than 18 hours before birth
  • Infection of the placenta tissues and amniotic fluid (chorioamnionitis)

Babies with late-onset neonatal sepsis are infected after delivery. The following increase an infant's risk for sepsis after delivery:

  • Having a catheter in a blood vessel for a long time
  • Staying in the hospital for an extended period of time

What are the symptoms for Neonatal Sepsis?

Infants with neonatal sepsis may have the following symptoms:

  • Body temperature changes
  • Breathing problems
  • Diarrhea or decreased bowel movements
  • Low blood sugar
  • Reduced movements
  • Reduced sucking
  • Seizures
  • Slow or fast heart rate
  • Swollen belly area
  • Vomiting
  • Yellow skin and whites of the eyes (jaundice)

What are the current treatments for Neonatal Sepsis?

Babies younger than 4 weeks old who have fever or other signs of infection are started on intravenous (IV) antibiotics right away. (It may take 24 to 72 hours to get lab results.) Newborns whose mothers had chorioamnionitis or who may be at high risk for other reasons will also get IV antibiotics at first, even if they have no symptoms.

The baby will get antibiotics for up to 3 weeks if bacteria are found in the blood or spinal fluid. Treatment will be shorter if no bacteria are found.

An antiviral medicine called acyclovir will be used for infections that may be caused by HSV. Older babies who have normal lab results and have only a fever may not be given antibiotics. Instead, the child may be able to leave the hospital and come back for checkups.

Babies who need treatment and have already gone home after birth will most often be admitted to the hospital for monitoring.

What is the outlook (prognosis) for Neonatal Sepsis?

Many babies with bacterial infections will recover completely and have no other problems. However, neonatal sepsis is a leading cause of infant death. The more quickly an infant gets treatment, the better the outcome.

What are the possible complications for Neonatal Sepsis?

Complications may include:

  • Disability
  • Death

When should I contact a medical professional for Neonatal Sepsis?

Seek medical help right away for an infant that shows symptoms of neonatal sepsis.

How do I prevent Neonatal Sepsis?

Pregnant women may need preventive antibiotics if they have:

  • Chorioamnionitis
  • Group B strep colonization
  • Given birth in the past to a baby with sepsis caused by bacteria

Other things that can help prevent sepsis include:

  • Preventing and treating infections in mothers, including HSV
  • Providing a clean place for birth
  • Delivering the baby within 12 to 24 hours of when the membranes break (Cesarean delivery should be done in women within 4 to 6 hours or sooner of membranes breaking.)

REFERENCES

Committee on Infectious Diseases, Committee on Fetus and Newborn; Baker CJ, Byington CL, Polin RA. Policy statement - recommendations for the prevention of perinatal group B streptococcal (GBS) disease. Pediatrics. 2011;128(3):611-616. PMID: 21807694 www.ncbi.nlm.nih.gov/pubmed/21807694.

Esper F. Postnatal bacterial infections. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 48.

Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal morbidities of prenatal and perinatal origin. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 73.

Jaganath D, Same RG. Microbiology and infectious disease. In: The Johns Hopkins Hospital; Hughes HK, Kahl LK, eds. The Harriet Lane Handbook. 21st ed. Philadelphia, PA: Elsevier; 2018:chap 17.

Polin R, Randis TM. Perinatal infections and chorioamnionitis. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 25.

Verani JR, McGee L, Schrag SJ; Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59(RR-10):1-36. PMID: 21088663 www.ncbi.nlm.nih.gov/pubmed/21088663.

Top Global Doctors For Neonatal Sepsis

MS
Elite
Mike Sharland
London, ENG, GB
PH
Elite
Paul T. Heath
London, ENG, GB
DS
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Deepak K. Sharma
Jaipur, RJ, IN
NA
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Niek B. Achten
Blaricum, NH, NL

Latest Advances On Neonatal Sepsis

  • Condition: Preterm Growth-Restricted Infants
  • Journal: Mymensingh medical journal : MMJ
  • Treatment Used: Early Versus Delayed Enteral Feeding
  • Number of Patients: 50
  • Published —
In this study, researchers compared the effectiveness of early versus delayed enteral feeding for preterm growth-restricted infants.
  • Condition: COVID-19
  • Journal: Journal of proteome research
  • Treatment Used: Repurposing Bacillus Calmette-Guerin Vaccine
  • Number of Patients: 0
  • Published —
This article discusses re-purposing the Bacillus Calmette-Guerin vaccine against SARS-CoV-2.

Clinical Trials For Neonatal Sepsis

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Other, Dietary Supplement
  • Participants: 876
  • Start Date: February 1, 2021
The Potential Protective Effect of a Formula Supplemented With Fermented Matrices on the Risk of Developing Neonatal Sepsis
Clinical Trial
  • Status: Not yet recruiting
  • Intervention Type: Other
  • Participants: 600
  • Start Date: November 1, 2020
The Volume of Blood Submitted for Culture in Neonates - a Multicentre Initiative to Improve the Value of the Test by Bedside Weighing of Blood Samples.