Neonatal sepsis, also known as sepsis neonatorum and neonatal septicemia, is a bacterial blood infection found in newborn infants younger than 3 months . It can be a life threatening condition unless treated at an early stage.
Different kinds of bacteria, including Listeria, E.coli (Escherichia coli), Group B Streptococcus, Haemophilus influenza and Klebsiella pneumonia are generally responsible for this infection. Risk factors include:
Caused by different organisms like Coagulase-negative Staphylococcus, Staphylococcus aureus, E.coli and GBS, risk factors for late-onset neonatal sepsis include:
Neonates are highly vulnerable to bacterial infection due to their low non-specific and specific immunity, such as chemotaxis response delay, low phagocytosis, low or no IgA (immunoglobulin A) and IgM (immunoglobulin M) and low complement levels (a type of blood protein that functions alongside antibodies during immune responses) .
The early-onset type of the infection is usually obtained from the blood stream of the mother or by aspiration or ingestion of contaminated amniotic fluid. In late onset sepsis, bacterial invasion generally occurs through the gated umbilical stump, nose, skin, mucus membranes of the eyes, ear, pharynxes as well as internal systems like the respiratory, urinary, gastrointestinal and nervous systems. Babies may also get contaminated from other babies, adults (parents, caregivers) and objects.
A swab test performed between the 35th week and the 37th week can determine whether the mother is carrying the GBS bacteria. Women with a positive swab test result are given intravenous antibiotics around 4 hours before delivery so that the infection does not transmit to the baby .
A fever when in labor, a premature rupture of membranes or a history of having children with sepsis (or any other GBS infection) increases the chances of carrying the bacteria. So, women with these risk factors are given IV antibiotics in labor to reduce the risk of infection in the newborn. Delivering the baby within 24 hours of labor and providing a clean birth environment can also help with the prevention .
Preventive measures for the late-onset form include:
Most diagnostic tests involve checking for bacteria in the baby’s body.
The treatment depends on the type, severity and location of the infection. It may continue for 7 to 21 days after the diagnosis is confirmed by a culture test . Neonates suspected to have sepsis at birth are immediately given empirical antibiotic treatment, before a confirmed diagnosis . Ampicillin is an antibiotic medication commonly used for this purpose . Doctors may also employ the following treatment options:
Mild cases of late-onset sepsis can be treated without antibiotics . Instead, the affected babies are closely monitored on an outpatient basis.
Neonatal sepsis associated with meningitis, extracorporeal membrane oxygenation therapy, prolonged hypoxia and brain abscess generally need long-term follow-up treatment (continuing several years) for assessing proper neurodevelopment .
Failing to address the infection early can lead to organ damage, disability and even death. Studies show neonatal sepsis to be one of the main causes of infant death. However, proper early treatment can cure the problem completely with no side effects or complications .
Sepsis associated with meningitis may lead to the following complications :
It is considered an uncommon condition, occurring in 2 to 4 out of every 1000 live births .
The ICD-9 code used for indicating neonatal sepsis is 771.81  while its ICD-10 code is P36 .