Neonatal Sepsis

Neonatal Sepsis

Introduction

Neonatal sepsis, also referred to as “sepsis neonatorum”, is a condition of the new born infant. It may be defined as, “a clinical syndrome of bacetremia, in which the newly born infant is affected, showing symptomatic signs of infection, within the first four weeks of life”.

The sepsis may be either localized to a single location in the body or may cause infection throughout the body (septicemia). Localization may occur mostly in the meningies, causing meningitis, or may result in pneumonia (localization in lungs).

Neonatal sepsis is the most common cause of infant death. Diagnosis of sepsis may result in saving such cases from fatality. This can only be possible if the condition is diagnosed at an early stage and treated with utmost care by use of antibiotics.

Discussion

Neonatal sepsis is a life threatening condition, in which a new born child is under the influence of bacetremia. It can be categorized as early or late sepsis, according to its onset. The early onset of this infection is within 24-48 hrs of birth, and a late onset occurs within 48-72 hrs of the birth of the infant.

Etiology

The micro-organisms associated with early neonatal sepsis are (Klinger G, Levy I, et. al Jul 2009).

Group B Streptococcus (GBS) ,Escherichia collie, Haemophilius influenzae , Coagulase-negative Staphylococcus, Listeria monocytogenes

Risk factors associated with early neonatal sepsis:

The risk factors associated with early onset of this syndrome are;

Colonization of GBS in the maternal cavity, especially if it is left untreated during labor.

Premature rupture of membranes

Prolonged rupture of membranes

Premature delivery

Maternal UTI (urinary tract infections)

Other factors leading to sepsis are; poor prenatal care, difficult delivery, recurrent abortion history, low birth weight and congenital abnormalities etc.

The organisms considered to be associated with the late onset of neonatal sepsis are; Coagulase negative staphylococci, klebsiella, and pseudomonas etc.

Risk factors associated with late neonatal sepsis

The risks associated with late neonatal sepsis include;

Premature delivery

Central venous catherization

CPAP (continuous positive air pressure) use

PPIs (proton pump inhibitors) use

GI tract pathology

Epidemiology

The occurrence of this syndrome in the United States, according to a research, is found to be 0.2%, i.e. 2 per 1000 of live births. Many newborns do not show specific signs of this disease, therefore it is now considered by the AAP (American Academy of Pediatrics) and AAOG (American Academy of Obstetrics and Gynecology), to screen for neonatal sepsis before the occurrence of the symptoms of this disease. (American academy of pediatrics, 2003), (Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Aug 16 2002)

Since the rate of infant death is as high as about more than 50% if the diagnosis is not made before hand, therefore it is necessary to take preventive measures before the actual culture results are known.

Pathophysiology

Over the past years, the microbial resistance has increased in context to many diseases (Morales WJ, Aug 1999). Since neonatal sepsis is a bacterial associated disease, the resistance of organisms associated with this disease has amplified over the past 50 years. This problem has resulted in further complicating the treatment ...