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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 between days 8 and 89.
CAUSES
A number of different bacteria, including Escherichia coli (E.coli), Listeria, and certain strains of streptococcus, may cause neonatal sepsis. Early-onset neonatal sepsis most often appears within 24 hours of birth. The baby gets the infection from the mother before or during delivery. The following increases an infant's risk of early-onset sepsis:
Group B streptococcus infection during pregnancy Preterm delivery Water breaking (rupture of membranes) that lasts longer than 24 hours before birth Infection of the placenta tissues and amniotic fluid (chorioamnionitis)
Babies with late-onset neonatal sepsis get infected after delivery. The following increase an infant's risk of sepsis after delivery:
Having a catheter in a blood vessel for a long time Staying in the hospital for an extended period of time
Symptoms
Body temperature changes Breathing problems Diarrhea Low blood sugar Reduced movements
Reduced sucking Seizures Slow heart rate Swollen belly area Vomiting Yellow skin and whites of the eyes (jaundice)
Laboratory tests can help diagnose neonatal sepsis and identify the bacteria that is causing the infection. Blood tests may include:
A lumbar puncture (spinal tap) will be done to examine the cerebrospinal fluid for bacteria. If the baby has a cough or problems breathing, a chest x-ray will be taken. Urine culture tests are done in babies older than several days.
Treatment
Babies in the hospital and those younger than 4 weeks old are started on antibiotics before lab results are back. (Lab results may take 24-72 hours.) This practice has saved many lives. Older babies may not be given antibiotics if all lab results are within normal limits. Instead, the child may be followed closely on an outpatient basis. Babies who do require treatment will be admitted to the hospital for monitoring.
Outlook (Prognosis)
With prompt treatment, many babies with these bacterial infections will recover completely with no remaining problems. Nevertheless, neonatal sepsis is a leading cause of infant death. The more quickly an infant receives treatment, the better the outcome.
Possible Complications
Disability Death
Seek immediate medical help if your infant shows symptoms of neonatal sepsis.
Prevention
Preventative antibiotics may be given to pregnant women who have chorioamnionitis, Group B strep, or who have previously given birth to an infant with sepsis due to the bacteria. Preventing and treating infections in mothers, providing a clean birth environment, and delivering the baby within 24 hours of rupture of membranes, where possible, can all help lower the chance of neonatal sepsis.
Alternative Names