Neonatal Sepsis

What is neonatal sepsis? 

Neonatal sepsis is a bloodstream-related infection in infants under 28 days old. The infection causes issues of mortality and morbidity among newborn babies. It is more common in countries with lower to middle income. Preterm neonates or premature babies are at higher risk of developing this infection than term neonates. 

Different types of neonatal sepsis

Neonatal sepsis is divided into two types depending on their time of occurrence after birth: 

• Early-onset neonatal sepsis (EONS/ EOS): 

EOS occurs when pathogens transfer from the female genitourinary system to the fetus or the infant. It happens at or before 3 days of the baby’s life. Some experts also observe EONS under 7 days of birth. These pathogens can infect the amniotic fluid and reach the uterus, vagina, and cervix. Infants can catch EOS during delivery. 

• Late-onset neonatal sepsis (LOS):

LOS sepsis occurs in infants at or after 3 days of life. The pathogens from the surrounding environment infect infants after delivery. Procedures related to the mucosa, such as intravascular catheter insertion, may also lead to LOS.

Common symptoms of neonatal sepsis

Symptoms of neonatal sepsis are subtle. Thus, it is It is hard to detect them without proper diagnosis. However, these are some of the signs to look for:

• Heavy sleeping
• Reluctant to feeding
• Irritable
• Breathing pauses and rapid breathing 
• Diarrhoea
• Vomiting
• Fever over 100.4 °F
• Pale skin
• Low body temperature 

What causes neonatal sepsis?

Different pathogens and factors lead to either EOS or LOS sepsis in infants.

• Causes for EOS 

Pathogens such as Escherichia coli, Group B streptococcus (GBS), Listeria monocytogenes, coagulase-negative Staphylococcus, and Haemophilus influenza are responsible. Additionally, some maternal factors also increase the risk of EOS in infants. For example, GBS colonisation, chorioamnionitis, premature delivery (before 37 months), over 18 hours long membrane ruptures etc. 

• Causes for LOS

Pathogens travel to infants through surrounding conditions such as contact with caregivers or healthcare staff. In preterm neonates, the poor and innate immune system and excessive use of invasive devices increase the risk of LOS. Other known causes of LOS include late manifestation of vertically transmitted infection and contact with Staphylococcus epidermidis. 

When should you see a doctor? 

Neonatal sepsis is a medical emergency. If your infant shows any signs and symptoms of sepsis, immediately provide them with medical care. Sepsis tends to worsen with time. Thus infected infants must get antibiotics as soon as possible. 

Possible complications

Neonatal sepsis causes various health issues and complications in newborns. Such as: 

• Infants with low birth weight may suffer impaired mental and psychomotor development, visual and hearing deficits and cerebral palsy. 
• Mortality and morbidity in infants
• Increases risk of chronic lung diseases in VLBW infants

Remedies/Treatment  

Once the sepsis diagnosis is detected, the infected newborn should receive antibiotics immediately. Thus, it is best to visit neonatologists or paediatricians for infection management. Visit a Pediatric infectious diseases specialist if your newborn is not responding to antibiotics. 

Pediatric surgery will be required to deal with necrotising fasciitis, abscess, omphalitis, and other surgical complications. It is recommended to visit Pediatric pharmacists to ensure your infant is not consuming toxic antibiotic levels. 

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