Neonatal sepsis

1. NEONATAL SEPSIS

3. NEONATAL SEPSIS
Neonatal sepsis or sepsis neonatrum or neonatal
septicemia occurs when pathogenic bacteria gain
access into the blood stream.
Neonatal septicemia occurs in infants less than 90
days of age, late onset sepsis occurs after 1 week
of age with in 90 days.

4. ETIOLOGY
A no. of different bacteria including e.coli hysteria &
certain strains of streptococcus may cause neonatal
sepsis.

5. ETIOLOGY
EARLY ONSET NEONATAL SEPSIS
 Early onset neonatal sepsis most
often appears with in 24 hours of
birth.
 The baby gets infected from mother
or during the delivery.
LATE ONSET NEONATAL SEPSIS
 Baby get infected after delivery by the
organisms thriving in the external
environment of the home or hospitals.

6. The following increases an infant’s risk of early onset sepsis-
 Preterm delivery & low birth weight baby.
 Group B streptococcus infection during pregnancy.
 Premature rupture of membranes
 Infection of placental tissues & amniotic fluid
 Maternal fever & infection.
EARLY ONSET NEONATAL SEPSIS

7. The following increases an infant’s risk of Late onset sepsis-
 Hospital stay for long time.
 Unhygienic.
 Having intracath in blood vessels for long time.
 LBW
 Lack of breastfeeding.
 Superficial infection e.g umbilical sepsis.
Etc…….
LATE ONSET NEONATAL SEPSIS

8. Contd…….
 All these factors enhance of
entry of organisms into the
body of neonates who have
low immunity as compared
to others.

9. CLINICAL FEATURES
 The manifestation of Neonatal septicemia, are subtle vague,& non-
specific.
 The most common complaint concerning infant’s progress is “failure
to do well” or “ not looking right.”
 Hypothermia is common manifestation.

10.  All the body system tend to shown some indications of sepsis which are
as follows;-
 CIRCULATORY SYSTEM-
 Pallor, cyanosis or mottling.
 Cold, clammy skin
 Hypotension & shock
 Edema
 Bradycardia & tachycardia

11. Contd…
 RESPIRATORY SYSTEM
 Irregular respiration, apnea or trachypnea
 Cyanosis
 Grunting
 Dyspnea
 Retractions
 pneumonia

12. CENTRAL NERVOUS SYSTEM :
Reduced activity, lethargy ,cry poor cry.
Increased activity- irritability ,tremors
Full fontanel
Abnormal eye movements

13. GASTRO INTESTINAL SYSTEM
Poor feeding ,refuse to suckle.
Vomiting.
Diarrhea or decreased stool passage.
Abdominal distension.
Hepatomegaly.

14. HEPATOPOIETIC SYSTEM
Jaundice
Pallor
Petechiae, ecchymosis
Spleenomegaly ,bleeding

15. DIAGNOSTIC EVALVUATION
Culture of blood ,urine & C.S.F
Complete blood count(C.B.C)
ESR ( test that indirectly measures the degree of inflammation
present in the body.)

16. MANAGEMENT
For babies with neonatal sepsis, supportive care &
antibiotic therapy are 2 important components of
treatment.
 SUPPORTIVE CARE-
1. Provide warmth. The septic neonate should be nursed in
thermo neutral environment.

17. Start intravenous line, infuse normal saline 10 ml/kg over
5-10 minutes.
Infuse 10% glucose ,2 ml /kg stat to manage
hypoglycemia.
Administer injection vitamin k , 1 mg IM to prevent
bleeding.

18. Avoid oral feeding if baby is very sick & give I/V
fluids.
In neonates with sclerema ,exchange transfusion
with fresh whole blood may be required.

19. ANTIBIOTIC THERAPY
Antibiotic therapy should cover common
causative bacteria like; E.coli, staphylococcus
aureus & klebisella pneumoniae.

20. ANTIBIOTIC THERAPY IN NEONATAL SEPSIS
 A combination of ampicillin and gentamycin for the treatment of sepsis and
pneumonia.
1. Inj. Ampicillin 50mg/kg/dose, IM/IV 7-10 days.
2. Inj. Gentamycin 2.5mg/kg/dose, IM/IV 7-10 days.
 In suspect of meningitis, cefotaxime should be used along with aminoglycoside,
Inj. Ampicillin 100mg/kg/dose, IM/IV 3 weeks
+
Inj. Gentamycin 2.5mg/kg/dose, IM/IV 3 weeks
+
Inj. Chloramphenicol 12mg/kg, IV, 3 weeks.
* The antibiotic choices depends on the causative organism detected in the culture.

21. PROGNOSIS
The prognosis is variable, severe neurologic & respiratory
problems may occur in low birth weight babies as a result
of early onset sepsis.
Late onset sepsis & meningitis may result in poor
outcomes.