All You Need To Know About Neonatal Sepsis

Neonatal sepsis, also known as sepsis in neonates, is a dangerous medical condition which occurs when a baby younger than 28 days old has a life-threatening response to an infection. Neonatal sepsis is most frequently caused by bacterial infections. One of the biggest causes of newborn morbidity and death, particularly in middle-class and lower-income nations, is still neonatal sepsis. Depending on when the patient first presents after delivery, specialists classify it as either early-onset sepsis (EOS) or late-onset sepsis (LOS), with a 72-hour or 7-day cutoff.

When your body reacts severely to an infection, it might lead to sepsis. The entire body may be inflamed in a newborn who contracts an infection and goes into sepsis. Reduced blood flow to your baby's critical organs and limbs results from this inflammation and blood clotting. Organ failure and even death may result from it. Sepsis in a newborn is a medical emergency. Your infant requires immediate antibiotic treatment.

What is Neonatal Sepsis?

Neonatal sepsis refers to an infection involving the bloodstream in newborn infants less than 28 days old. It remains a leading cause of morbidity and mortality among neonates, especially in middle and lower-income countries.

Based on the age of onset, healthcare professionals classified neonatal sepsis into two different categories. These include:

• Early-onset neonatal sepsis: Sepsis that manifests within the first 72 hours of birth is referred to by most healthcare professionals as "early-onset neonatal sepsis.
• Late-onset neonatal sepsis: Sepsis developing after three days of life is referred to as "late-onset neonatal sepsis" by the majority of healthcare professionals.

What are the Causes of Neonatal Sepsis?

Bacteria including Listeria, Escherichia coli (E coli), and some streptococcus strains can result in neonatal sepsis. Sepsis in newborns has been linked to Group B streptococcus (GBS). Nonetheless, due to prenatal GBS screening, this issue has become less prevalent. A newborn baby may also get a serious infection from the herpes simplex virus (HSV). When the mother has a recent HSV infection, this occurs most frequently.  Most frequently, 24 to 48 hours after birth is when early-onset neonatal sepsis manifests. The infection is passed from the mother to the infant before or after delivery. A baby's risk of developing early-onset bacterial sepsis is increased by the following:

• Colonization of GBS during pregnancy
• Premature birth
• Infection of the amniotic fluid and placenta tissues (chorioamnionitis)
• If water breaking (membrane rupture) occurs more than eighteen hours before delivery

After birth, newborns that have late-onset neonatal sepsis become contaminated. An infant's chance of developing sepsis after delivery is increased by the following: 

• Long-term placement of a catheter in a blood vessel
• Prolonged hospital stays

What are the Symptoms of Neonatal Sepsis?

The following are the symptoms of neonatal sepsis in newborns:

• Variation in body temperature; hyperthermia and hypothermia
• Slower or faster heart rate
• Trouble in breathing
• Vomiting
• Diarrhea
• Trouble in feeding
• Cold hands and feet
• Swollen abdomen or belly
• Reduced sucking and other body movements
• Yellowing of skin and eye whites (jaundice)
• Seizures

What are the Diagnosis of Neonatal Sepsis?

To identify newborn sepsis, medical professionals follow certain protocols. They will assess the baby's symptoms and inquire about your past medical records.  A series of tests intended to determine the etiology of your baby's infection is called a sepsis work-up. This includes:

• Blood tests: This includes complete blood count (CBC), CRP (C-reactive protein) and blood cultures
• Urine tests: This includes urinalysis and urine culture
• Imaging tests: This includes chest X-rays or MRI
• Spinal tap, also known as lumbar puncture: To extract spinal fluid and check for infections, a medical professional will insert a very tiny needle into the space surrounding your baby's spine.

What are the Management and Treatment of Neonatal Sepsis?

Treatment for newborn sepsis must start immediately. Your baby may be admitted to an intensive care unit (ICU) by your baby's medical professional. Treatment options for neonatal sepsis include:

• Fluids administered intravenously (IV)
• IV antibiotics for the treatment of bacterial illnesses
• Antiviral drugs to combat viral infections
• Blood pressure and/or heart medicines
• If necessary, more oxygen and other respiratory supports
• Blood transfusions if needed

What are the Complications of Neonatal Sepsis?

The majority of neonates who recover from sepsis experience no further problems. However, a lot of newborns that make it survive have long-term health problems. The cognitive skills of about one-third of babies who survive sepsis will be delayed. Following their recuperation, over half of newborn sepsis survivors visit the hospital once more. 

Meningitis, an infection of the membranes encircling the brain, occurs in certain infants. Babies with this illness may experience severe symptoms and adverse outcomes, such as:

• Hearing loss
• Lethargy
• Developmental delaying
• Bulging of the soft spot between their skull bones
• Cerebral palsy
• Seizures
• Coma 

When should I take my Newborn to the Emergency Room?

When your baby exhibits any of the following sepsis signs after you've returned home from the hospital visit the closest emergency room: 

• Your baby is unusually sleepier or irritable  than normal
• The skin of the baby is pale, cold, or discolored
• Over a 12-hour period, your infant has been wearing dry diapers
• Your baby is not responding or having trouble breathing.

Conclusion

Having a newborn can cause you to worry about a lot of different things. Probably not one of them had neonatal sepsis. However, get help as soon as possible if you believe your baby may have this potentially fatal illness. Sepsis in neonates is a medical emergency. Your baby will heal better the sooner you get them medical attention. 

Get expert insights from Surya Hospitals to ensure the best care for your newborn.

Frequently Asked Questions (FAQs)

Q: Is a newborn's sepsis curable?
A: Newborn sepsis can be treated. A large number of neonates with sepsis recover fully and experience no further complications. However, one of the most common reasons for infant mortality is neonatal sepsis. Your baby's prognosis will improve with prompt care. For every hour that goes by without treatment, the chance of dying from sepsis rises by roughly 7.6%.

Q: How to prevent neonatal sepsis?
A: Ensuring that all babies receive essential newborn care (ENC), which includes optimal cord care, early beginning and exclusive breastfeeding, maintenance of warmth, and rapid antibiotic treatment could help prevent the majority of newborn deaths caused by infection.