Neonatal Sepsis: Causes, Signs and Treatment

Neonate means infant younger than four weeks and sepsis means any type of infection; thus when the two terms are put together they mean infection in an infant. Neonatal sepsis is also called neonatal septicemia or sepsis neonatorum. The symptoms of the disease are observed before the child completes 3 months.

Causes of Neonatal Sepsis

Neonatal sepsis cases are more common in premature babies. The disease can be classified as: congenital, early-onset and late-onset. Congenital neonatal sepsis is when the child is infected during pregnancy i.e. before birth. The baby can be infected by virus through placenta or birth canal. HIV (Human Immunodeficiency Virus), syphilis are some of the viruses that can infect the child before delivery. Early-onset neonatal sepsis is when the infant is infected, while taking birth or soon after the delivery. Group B streptococcus (GBS) and Escherichia coli (E. coli) are considered as chief viruses that infect the baby, while birth. Early-onset neonatal sepsis is a result of asymptomatic colonization in the intestinal or genital tract of the mother. Colonization is existence of bacterias/viruses in a body part. An infant is said to be affected by late-onset neonatal sepsis, when it is infected a few days after delivery. This infection can be due to the organisms present in the environment of the hospital. After getting discharged from hospital, babies can get infected due to the bacterias present in the environment at home. GBS and E. coli are also responsible for late-onset neonatal sepsis.

Risk Factors of Neonatal Sepsis

There are number of risk factors related to the infant getting affected by neonatal sepsis. Males are noticed to be infected more than females, the ratio being 2:1. Risk factors of early-onset neonatal sepsis:

• Frequent vaginal checkups during pregnancy.
• Premature birth
• Infected placenta
• GSB infection to the mother during pregnancy.

Risk factors of late-onset neonatal sepsis:

• Infected hospital environment
• Staying in hospital for a long period of time.

Symptoms of Neonatal Sepsis

Symptoms of early-onset neonatal sepsis are observed mostly within 24 hours of delivery, while that of late-onset neonatal sepsis can be observed between 8th-89th day of delivery. The following list gives the symptoms observed in infants suffering from neonatal sepsis:

• Unstable body temperature
• Unable to suck breast milk properly.
• Apnea
• Fever in rare cases.
• Vomiting and diarrhea
• Respiratory distress
• Reduced heart rate
• Jaundice
• Belly area may be swollen

Diagnosis of Neonatal Sepsis

Physical examination of the baby and the laboratory tests help to diagnose neonatal sepsis. The physical examination include, assessing the body temperature, heart rate, breathing, etc. The laboratory tests aim at finding out the bacteria/virus that has caused infection. Blood tests that are performed on the infant, consist of WBC count, platelet count, blood culture, etc. Chest X-rays and urine tests are performed, when infection due to bacteria is suspected.

Treatment of Neonatal Sepsis

Neonatal sepsis should be treated at the earliest because the immune system of an infant is not completely developed and the infection may be fatal. Antibiotics are recommended when diagnosis of neonatal sepsis is not yet confirmed. This can help prevent further complications. Further treatment depends on the result of the laboratory tests. Infections caused due to GSB and E. coli are given medications, like ampicillin and gentamicin. These medications help in curing early-onset neonatal sepsis. Intravenous immune globulin replacement, granulocyte transfusion are the treatments given, if the infection is too severe. If the baby is given the proper treatment, it can recover soon from the infection. Pregnant women having GSB infection can be given antibiotics that can prevent the baby from getting infected by the same.

A child suffering from neonatal sepsis should be given treatment at the earliest. Chances of the baby getting infected by neonatal sepsis can be reduced, if the delivery is done in a germ-free environment, proper care of mother is taken during pregnancy and exposing the child to any infection after delivery is avoided. Premature babies are highly susceptible to neonatal sepsis, so baby care should be taken to a great extent. In United States, neonatal sepsis cases are found in 1-8 live births among 1000. 50% mortality rate has been noticed, if neonatal sepsis goes untreated.