Neonatal sepsis is a serious bloodstream infection that occurs in newborn babies during the first 28 days of life. It is one of the leading causes of neonatal morbidity and mortality worldwide, especially in developing countries. Early recognition and treatment are crucial because neonatal sepsis can progress rapidly and become life-threatening.
This blog will cover the causes, risk factors, symptoms, diagnosis, treatment, and prevention of neonatal sepsis.
What is Neonatal Sepsis?
Neonatal sepsis is defined as a bacterial, viral, or fungal infection in a newborn’s blood or other tissues. It is classified into two main types:
- Early-Onset Sepsis (EOS) – Appears within the first 72 hours of life, often acquired from the mother during delivery.
- Late-Onset Sepsis (LOS) – Occurs after 72 hours of birth, commonly associated with hospital-acquired infections or community exposure.
Causes and Risk Factors of Neonatal Sepsis
Causes
The most common microorganisms responsible for neonatal sepsis include:
- Bacteria: Group B Streptococcus, Escherichia coli, Klebsiella, Staphylococcus aureus
- Viruses: Herpes simplex virus, enteroviruses
- Fungi: Candida species (particularly in premature or immunocompromised babies)
Risk Factors
- Premature birth (before 37 weeks)
- Low birth weight
- Prolonged rupture of membranes (>18 hours before delivery)
- Maternal infection (urinary tract infection, chorioamnionitis)
- Lack of proper hygiene in neonatal care units
- Use of invasive devices such as catheters or ventilators
Symptoms of Neonatal Sepsis
Newborns may not always show specific signs of infection, which makes diagnosis challenging. Common symptoms include:
- Poor feeding or refusal to feed
- Lethargy or excessive sleepiness
- Fever or low body temperature (hypothermia)
- Breathing problems (rapid breathing, apnea)
- Irritability or excessive crying
- Seizures
- Jaundice (yellowing of skin or eyes)
- Abdominal distension or vomiting
Diagnosis of Neonatal Sepsis
Since symptoms are often non-specific, laboratory investigations are essential. Diagnosis may involve:
- Blood cultures – to identify the causative organism
- Complete blood count (CBC) – showing abnormal white blood cell count
- C-reactive protein (CRP) and Procalcitonin – infection markers
- Lumbar puncture (CSF analysis) – if meningitis is suspected
- Urine culture – in late-onset sepsis cases
Treatment of Neonatal Sepsis
Prompt treatment is critical to reduce complications and mortality. Management typically includes:
- Antibiotics
- Broad-spectrum antibiotics (ampicillin, gentamicin, or cephalosporins) are given initially.
- The antibiotic choice is adjusted based on culture results.
- Supportive Care
- Oxygen therapy or ventilatory support for breathing difficulties
- Intravenous fluids for hydration and nutrition
- Temperature regulation (preventing hypothermia)
- Antifungal or Antiviral Medications
- Used if fungal or viral infection is confirmed.
Complications of Neonatal Sepsis
If untreated or diagnosed late, neonatal sepsis can lead to:
- Meningitis
- Septic shock
- Multi-organ failure
- Long-term neurological damage
- Death
Prevention of Neonatal Sepsis
- Proper antenatal care and screening of mothers for infections (e.g., Group B Strep).
- Maintaining sterile techniques during delivery.
- Breastfeeding to strengthen immunity.
- Strict hand hygiene and infection control in neonatal intensive care units (NICUs).
- Avoiding unnecessary invasive procedures.
Conclusion
Neonatal sepsis is a life-threatening condition that requires urgent medical attention. Early recognition of symptoms, timely diagnosis, and immediate treatment can save lives. Preventive measures such as good maternal care, hygiene practices, and breastfeeding play a vital role in reducing the burden of neonatal infections.
Parents and caregivers must remain alert for any unusual symptoms in newborns and seek medical help promptly to ensure healthy growth and development.
