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25-07-2024 Team Medicover Infectious-Diseases

Understanding Neonatal Sepsis: Causes and Symptoms

Neonatal sepsis is a severe infection in newborns that can lead to significant health complications if not diagnosed and treated promptly. This article aims to empower you with the knowledge to understand the causes, symptoms, and various factors associated with neonatal sepsis so you can take proactive steps to protect your newborn.

What is Neonatal Sepsis?

Neonatal sepsis is a blood infection that occurs in an infant younger than 28 days old. Bacteria, viruses, or fungi can cause it. Early diagnosis and treatment are crucial to prevent severe complications or death.

Causes of Neonatal Sepsis

Neonatal sepsis can be categorized into two types based on the time of onset:

Early-Onset Sepsis (EOS)

Early-onset sepsis occurs within the first 72 hours of life and is often contracted from the mother during childbirth. Common causes include:

Group B Streptococcus (GBS) : This bacterium is the most common cause of early-onset neonatal sepsis. Pregnant women are usually screened for GBS, and antibiotics can be administered during labour to reduce the risk.
Escherichia coli (E. coli) : This bacterium can be transmitted from the mother to the newborn during delivery.
Listeria monocytogenes : Though less common, this bacterium can cause severe infections and is often contracted through contaminated food consumed by the mother.

Late-Onset Sepsis (LOS)

Late-onset sepsis occurs after the first 72 hours of life and can be acquired from the environment. Common causes include:

Staphylococcus aureus : This bacterium can cause severe infections in newborns, particularly those in neonatal intensive care units (NICUs).
Candida species : These fungi can cause infections, especially in premature infants with compromised immune systems.
Klebsiella and Pseudomonas species : These bacteria can be found in hospital settings and are often resistant to multiple antibiotics.

Symptoms of Neonatal Sepsis

The symptoms of neonatal sepsis can be subtle and non-specific, making it challenging to diagnose. However, some common signs include:

Fever or Hypothermia : Abnormal body temperature, either high or low, can be a sign of infection.
Breathing Problems : Rapid breathing, grunting, or apnea (pauses in breathing) can indicate respiratory distress.
Feeding Difficulties : Poor feeding, vomiting, or a swollen abdomen can be symptoms of sepsis.
Lethargy or Irritability : Unusual sleepiness or fussiness can be a warning sign.
Jaundice : Yellowing of the skin and eyes can occur in septic newborns.
Seizures : In severe cases, seizuresmay occur.

Risk Factors for Neonatal Sepsis

Certain factors can increase the risk of neonatal sepsis:

Maternal Factors

Infection During Pregnancy : Maternal infections such as urinary tract infections (UTIs) or chorioamnionitis (infection of the fetal membranes) can increase the risk.
Premature Rupture of Membranes (PROM) : When the amniotic sac ruptures more than 18 hours before delivery, the risk of infection increases.
Group B Streptococcus Colonization : As mentioned earlier, GBS is a significant cause of early-onset sepsis.

Neonatal Factors

Prematurity : Premature infants have underdeveloped immune systems, making them more susceptible to infections.
Low Birth Weight : Infants weighing less than 2500 grams are at higher risk.
Invasive Procedures : Newborns who undergo invasive procedures such as catheter insertion or mechanical ventilation are more prone to infections.

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Diagnosis of Neonatal Sepsis

Diagnosing neonatal sepsis involves a combination of clinical evaluation and laboratory tests. Some standard diagnostic methods include:

Blood Tests

Complete Blood Count (CBC) : This test checks for abnormal white blood cell counts, which can indicate infection.
C-Reactive Protein (CRP) : Elevated CRP levels can be a marker of inflammation and infection.

Blood Cultures

Blood cultures are essential for identifying the specific bacteria or fungi causing the infection. However, results can take 24-48 hours.

Lumbar Puncture

In some cases, a lumbar puncture (spinal tap) is performed to check for infections in the cerebrospinal fluid.

Neonatal Sepsis Calculator

Tools like the Kaiser Neonatal Sepsis Calculator can help healthcare providers assess the risk of sepsis in newborns. This calculator estimates the likelihood of sepsis by taking into account various factors such as maternal infections, gestational age, and clinical symptoms.

Treatment of Neonatal Sepsis

Prompt treatment is crucial for improving outcomes in neonatal sepsis. The primary treatment involves:

Antibiotics

Broad-spectrum antibiotics are usually started immediately, even before the specific cause is identified. Once the blood culture results are available, the antibiotics may be adjusted to target the identified pathogen.

Supportive Care

Newborns with sepsis often require supportive care, which may include:

Intravenous (IV) Fluids : To maintain hydration and electrolyte balance.
Oxygen Therapy : To ensure adequate oxygen levels in the blood.
Mechanical Ventilation : In severe cases, a ventilator may be needed to assist with breathing.
Nutritional Support : Special feeding methods may be required for infants who cannot feed orally.

Neonatal Sepsis Prevention

Preventing neonatal sepsis involves several strategies:

Maternal Screening and Treatment

GBS Screening : Pregnant women are usually screened for GBS between 35-37 weeks of gestation. If positive, antibiotics are administered during labour.
Vaccinations : Ensuring that mothers are up-to-date on vaccinations can reduce the risk of infections that can be passed to the newborn.

Hygienic Practices

Strict hygiene practices are essential in hospital settings to prevent the spread of infections. These include hand hygiene, sterilization of equipment, and isolation of infected infants.

Early Identification and Treatment

Prompt identification and treatment of maternal infections during pregnancy can reduce the risk of neonatal sepsis.

Conclusion

Neonatal sepsis is a severe condition that requires the expertise and dedication of healthcare providers to diagnose and treat it promptly, ensuring the best possible outcomes. Understanding the causes, symptoms, risk factors, and preventive measures can help parents and healthcare providers work together to protect vulnerable newborns.

By staying informed and vigilant, we can work towards reducing the incidence and impact of neonatal sepsis, paving the way for a healthier start for our youngest patients. With the right knowledge and preventive measures, we can look forward to a brighter future for newborn health.

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Frequently Asked Questions

Risk factors for neonatal sepsis include prematurity, low birth weight, prolonged rupture of membranes, and maternal infections during pregnancy. These factors increase a newborn's vulnerability to serious infections.

Neonatal sepsis can be prevented through maternal screening for infections, timely antibiotic administration during labor for Group B Streptococcus, maintaining strict hygiene in hospital settings, and promoting vaccinations for mothers to prevent infections passed to newborns.

The prognosis for a baby with neonatal sepsis depends on the promptness of diagnosis and treatment, the specific infecting organism, and the overall health of the newborn. Early intervention significantly improves outcomes, but severe cases can lead to long-term complications or even death despite treatment.

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