What is sepsis?Sepsis is a term for severe infection that is present in the blood and spreads throughout the body. In newborns, it is also called sepsis neonatorum or neonatal septicemia.
What causes sepsis?Sepsis can develop following infection by microorganisms including bacteria, viruses, fungi, and parasites. Infection in babies can be contracted during pregnancy, from the mother's genital tract during labor and delivery, or after birth from contact with others.
Sepsis in a newborn is more likely to develop when the mother has had pregnancy complications that increase the likelihood of infection. Such complications may include the following:
- premature rupture of the membranes (amniotic sac), or membrane rupture for an extended length of time
- bleeding problems
- a difficult delivery
- infection in the uterus or placental tissues
- fever in the mother
What microorganisms cause severe infections and sepsis in babies?
rubella (German measles)
Group B streptococcus (GBS)
respiratory syncytial virus (RSV)
varicella-zoster virus (chickenpox virus)
herpes simplex virus
Haemophilus influenzae type b (Hib)
Why is sepsis a concern?Sepsis can be life threatening for newborns, especially if the baby has a weakened immune system because of prematurity or another illness. When a baby's immature immune system cannot fight the microorganism, the infection can quickly spread and overtake the body, causing serious illnesses such as meningitis or pneumonia.
What are the symptoms of sepsis?Sepsis in newborns is not always easy to identify since newborn babies often do not show symptoms of infections in the same way older babies and children may show symptoms. The following are some of the symptoms of infection in newborn babies. However, each baby may experience symptoms differently depending upon the type of organism causing the infection and the severity and location of the infection. Symptoms of infection may include the following:
- apnea (stopping breathing) or difficulty breathing
- bradycardia (decreased heart rate)
- decreased temperature or temperature instability
- weak suck
- jaundice (yellow coloring of the skin and eyes)
How is sepsis diagnosed?A sepsis workup may be needed to help identify the location of the infection and type of microorganism causing the infection. A sepsis workup may include the following procedures:
- blood tests
- lumbar puncture (Also called spinal tap.) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.
- blood cultures
- urine culture (sometimes by suprapubic tap, insertion of a needle through the lower abdomen into the bladder)
- culture of fluids from inside tubes and catheters that are inserted in the baby
- x-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Treatment of sepsis:Specific treatment for sepsis will be determined by your baby's physician based on:
- your baby's age, overall health, and medical history
- extent of the disease
- your baby's tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Sepsis can be life threatening as the infection can affect several body systems at the same time. This can make providing treatment more difficult. Babies with sepsis will require care in the newborn intensive care unit (NICU), and may need antibiotics, other medications, and specialized treatment (such as a mechanical breathing machine). The healthcare team will be working to provide the best care to treat the infection and care for your baby.
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