Neonatal+Sepsis

Infant Suffering from Neonatal Sepsis ** What is Neonatal Sepsis? ** Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections. 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. 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.
 * Neonatal Sepsis

Pregnant women and their fetuses are monitored through the prenatal care of their obstetrician for any of the signs or symptoms of sepsis. Before the baby is born, women are screened for infectious diseases such as HIV, gonorrhea, syphilis, herpes, Chlamydia, hepatitis B, immunity to rubella and chickenpox. If the mother develops a fever during her pregnancy then she will be thoroughly examined. During labor, several indicators may raise concern regarding the possibility of neonatal sepsis. Abnormalities of fetal heart rate, maternal fever, premature separation of the placenta from the uterine wall, or foul smelling/cloudy amniotic fluid all indicate a high-risk labor and delivery. A number of different bacteria, including //Escherichia coli// (//E.coli//), //Listeria//, and certain strains of streptococcus such as Group B Streptococcus (GBS), may cause neonatal sepsis. There are two types of neonatal sepsis, early-onset and late-onset. 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: Babies with late-onset neonatal sepsis get infected after delivery. The following increase an infant's risk of sepsis after delivery: Infants with neonatal sepsis may have the following symptoms: ** Treatment for Neonatal Sepsis ** A complete evaluation for neonatal sepsis is always given to infants who are 28 days or younger with a rectal temperature greater than 100.4 degrees F. The doctor collects a complete history of pregnancy, labor, and delivery, does a physical examination and laboratory tests. Laboratory tests can be key in diagnosing neonatal sepsis and identifying the bacteria causing the infection. Blood tests that are normally preformed include a CBC (complete blood count), CRP (nonspecific marker for inflamation), blood chemistries (such as blood sugar, kidney and liver function tests), blood culture, and C-reactive protein. In addition to blood tests, positive cultures of body fluids such as blood, urine, and CSF (A spinal tap will be done to examine the cerebrospinal fluid for bacteria) help identify sepsis in the infant and help in the prescription of antibiotics. If the baby has a cough or problems breathing, a chest x-ray will be taken. Treatment of a septic infant requires antibiotics. More common than not, infants that are younger than 4 weeks and suspected to be septic are started on antibiotics before the lab results are back. Many lives have been saved by this because labs can take 24-72 hours to produce results. Older infants usually will start the antibiotic only when positive lab results have returned. A septic infant usually needs IV fluids and medications to control blood pressure and heart function. In addition, a septic infant will usually require nutritional support because they are too sick to feed. An infant can either be given a nasogastric tube that delivers breast milk/formula through the nose directly into the stomach, or an IV mixture of proteins, carbohydrates, and fats. Critically ill septic infants may also require a ventilator to assist in breathing.
 * Causes and Symptoms of Neonatal Sepsis **
 * Group B streptococcus (group b strep) infection during pregnancy
 * Preterm delivery
 * Rupture of membranes (placenta tissue) that lasts longer than 24 hours
 * Infection of the placenta tissues and amniotic fluid (chorioamnionitis)
 * Having a catheter in a blood vessel for a long time
 * Staying in the hospital for an extended period of time
 * 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)
 * Poor feeding
 * Unusual rashes

Mothers should have proper prenatal care and work with their doctor’s on preventing and treating infections. Doctor’s can give preventative antibiotics to pregnant women who have a Group B // Streptococcus // infection or who have previously given birth to an infant with sepsis due to the bacteria. This in addition with providing a clean birth environment, monitoring the newborn, and delivering the baby within 24 hours of rupture of membranes, where possible, can all help lower the chance of neonatal sepsis.
 * Prevention **