Neonatal septicaemia is a potentially life-threatening bloodstream and systemic infection that occurs during the neonatal period. It is caused by micro-organisms that may be passed to the baby from a mother’s birth canal in the immediate newborn period or from the surrounding environment a few days after birth.
Symptoms of sepsis may be non-specific and are usually related to the site of infection, the nature of the causative micro-organism and the body’s response to the infection. Common symptoms include lethargy, poor feeding, difficult or fast breathing, fast heart rate, a bluish or pale discolouration of the skin, vomiting and fever.
Risk factors for neonatal sepsis include prematurity, prolonged rupture of a mother’s water bag beyond 18 hours, maternal infection such as chorioamnionitis and maternal carriage of group B streptococcus within the birth canal. Methods of decreasing risk of neonatal sepsis include administration of antibiotics to mothers with the above-mentioned risk factors or facilitating delivery of a baby if a pregnant mother has chorioamnionitis. It is also very important to maintain safe practices such as hand washing before touching baby, ensure a clean environment around the baby and take precautionary measures such as restricting visiting access if someone is not well and wishes to see the baby.
Diagnosis is made on the basis of history, physical examination and investigations including analysis of blood, urine, cerebrospinal fluid or chest or abdominal X-rays and other imaging modalities.
The primary treatment for neonatal sepsis is the timely use of appropriate antibiotics for a sufficient duration of time, elimination of the source of infection and supportive treatment as required. Other measures may y include respiratory support (with oxygen therapy, CPAP or mechanical ventilation), nutritional support (with intravenous dextrose and hydration or total parenteral nutrition) and support of blood pressure.