Newborn Sepsis
Severe infection that is present in the blood and spreads throughout the body. In newborns, it is
also called sepsis neonatorum or neonatal septicemia.
Sepsis occurs when a serious infection causes the body's normal reaction to infection to go into
overdrive. With sepsis, bacteria and the toxins they create cause changes in a person's body
temperature, heart rate, and blood pressure, and can result in dysfunction of the body's organs.
Neonatal sepsis is the single most important cause of neonatal deaths in the community,
accounting for over half of them. If diagnosed early and treated aggressively with antibiotics and
good supportive care, it is possible to save most cases of neonatal sepsis.
What causes sepsis?
Sepsis can develop following infection by microorganisms including bacteria, viruses, fungi, and
parasites. Infection in babies can be contracted during pregnancy, from the mother's genital tract
during labour and delivery, or after birth from contact with others.
Sepsis in a newborn is more likely to develop when the mother has had pregnancy complications
that increase the likelihood of infection. Such complications may include the following:
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premature rupture of the membranes (amniotic sac), or membrane rupture for an extended
length of time
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bleeding problems
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a difficult delivery
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infection in the uterus or placental tissues
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fever in the mother
Babies can also develop sepsis by contracting infections after birth from infected persons or
objects. Babies in the newborn intensive care unit (NICU) are at increased risk for acquiring
nosocomial (hospital-acquired) infections. Many babies in the NICU are premature or have low
birthweight which makes them more susceptible to infection and more likely to need invasive
treatments and procedures. Microorganisms that normally live on the skin may cause infection if
they enter the body through catheters and other tubes inserted into the baby's body.
What microorganisms cause severe infections and sepsis in babies?
Prenatal
During Delivery
After Birth
rubella (German measles)
Group B streptococcus
(GBS)
respiratory syncytial virus
(RSV)
cytomegalovirus (CMV)
E. coli
Candida
varicella-zoster virus (chickenpox
virus)
herpes simplex virus
Haemophilus influenzae type b
(Hib)
Listeria monocytogenes
.
enterovirus
In newborns, group B strep is the most common cause of sepsis (infection of the bloodstream)
and meningitis (infection of the lining and fluid surrounding the brain) and a common cause of
pneumonia.
Why is sepsis a concern?
Sepsis can be life threatening for newborns, especially if the baby has a weakened immune
system because of prematurity or another illness. When a baby's immature immune system
cannot fight the microorganism, the infection can quickly spread and overtake the body, causing
serious illnesses such as meningitis or pneumonia.
What are the symptoms of sepsis?
Sepsis in newborns is not always easy to identify since newborn babies often do not show
symptoms of infections in the same way older babies and children may show symptoms. The
following are some of the symptoms of infection in newborn babies. However, each baby may
experience symptoms differently depending upon the type of organism causing the infection and
the severity and location of the infection. Symptoms of infection may include the following:
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apnea (stopping breathing) or difficulty breathing
bradycardia (decreased heart rate)
decreased temperature or temperature instability
weak suck
difficult in feeding
irritability
decreased tone
jaundice
decreased amount of urine
Diagnosing and Treating Sepsis
Because symptoms of sepsis can be vague in infants, laboratory tests play a crucial role in
confirming or ruling out sepsis:

Blood tests (including white blood cell counts) and blood cultures may be taken to
determine whether bacteria are present in the blood. Other blood tests may be done to see
how well certain organs, such as the liver and kidneys, are functioning.

Urine is usually collected by inserting a sterile catheter into the baby's bladder through
the urethra for a few seconds to remove urine; this will be examined under a microscope
and cultured to check for the presence of bacteria.

A lumbar puncture (spinal tap) may be performed, depending on the baby's age and
overall appearance. A sample of cerebrospinal fluid will be tested and cultured to
determine if the baby could have meningitis.

X-rays, especially of the chest (to make sure there isn't pneumonia), are sometimes taken.
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If the baby has any kind of medical tubes running into the body (such as IV tubes,
catheters, or shunts), the fluids inside those tubes may be tested for signs of infection.
Babies who are at increased risk for sepsis, such as premature or low birth weight babies, may
have preventive antibiotic treatment started as soon as cultures are taken. Most medications are
given intravenously (IV).
Sepsis can be life threatening as the infection can affect several body systems at the same time.
This can make providing treatment more difficult. Babies with sepsis will require care in the
newborn intensive care unit (NICU), and may need antibiotics, other medications, and
specialized treatment (such as a mechanical breathing machine).
http://kidshealth.org/parent/pregnancy_newborn/medical_problems/sepsis.html