What Is Neonatal Sepsis?

Neonatal sepsis is a serious infectious disease in the neonatal period. A systemic inflammatory response caused when pathogens invade the newborn's blood and grow, reproduce, and produce toxins. Neonatal sepsis often lacks the typical clinical manifestations, but progresses rapidly, and the dangerous condition becomes a characteristic of neonatal sepsis.

Basic Information

English name

septicemia of newborn

Visiting department

Pediatrics

Multiple groups

premature baby

Common causes

Common pathogens are bacteria, but can also be molds, viruses, etc.

Common symptoms

Reduced milk intake or milk rejection, lethargy or irritability, jaundice, bleeding tendency, etc.

Causes of neonatal sepsis

Because the immune system of the newborn is immature, the immune function is poor, and infection is extremely easy to occur. After infection, it is difficult to limit the infection and cause widespread inflammatory reactions throughout the body. The disease progresses rapidly. Common pathogens are bacteria, but they can also be other pathogens such as molds, viruses or protozoa.

Clinical manifestations of neonatal sepsis

Can be divided into early hairstyle and late hairstyle. Early onset usually starts within 7 days after birth. Most infections occur before or at birth. The pathogenic bacteria are mainly G-bacilli, such as E. coli, with multiple system involvement, dangerous illness, and high mortality. Late-onset onset occurs 7 days after birth. Infection occurs at or after birth. Pathogens are common to staphylococcus and Klebsiella pneumoniae, and there are often local infections such as umbilitis and pneumonia.

Early clinical manifestations of neonatal sepsis are often atypical, especially in preterm infants. It is manifested as reduced milk intake or milk rejection, galactorrhea, lethargy or irritability, low crying, fever, or temperature rise, but also can be manifested as normal body temperature, low response, pale or dark complexion, atrophy, weight loss Heterosexual symptoms.

Septicemia should be highly suspected when:

Jaundice

Sometimes the only manifestation of sepsis. It is manifested as delayed delayed jaundice, rapid deepening of jaundice, or recurrence of jaundice, which cannot be explained by other reasons.

Liver and spleen

Appears late, usually mild to moderately large.

3. bleeding tendency

Mucosal stasis, ecchymosis, purpura, bleeding at the needle eye, vomiting, blood in the stool, pulmonary hemorrhage, and DIC in severe cases.

4.Shock

Looking pale, skin pattern, decreased blood pressure, little or no urine.

5. Other

Respiratory distress, apnea, vomiting, bloating, toxic intestinal paralysis.

6. May be combined with meningitis, necrotizing enterocolitis, septic arthritis and osteomyelitis.

Neonatal sepsis examination

Peripheral blood routine

The total number of white blood cells is increased or decreased, the proportion of nucleus cells in neutrophils is increased, and the platelet count is increased.

2. Bacterial culture

(1) blood culture;

(2) Cerebrospinal fluid culture;

(3) urine culture;

(4) Culture of other secretions.

Negative culture results can not rule out sepsis due to low neonatal resistance and culture techniques.

3. C-reactive protein assay

After bacterial infection, C-reactive protein rises within 6 to 8 hours, and can decrease in a short time after the infection is controlled, so it is also helpful to observe the efficacy and prognosis.

Diagnosis of neonatal sepsis

The diagnosis of this disease can be considered based on high-risk factors in the medical history (such as mother's prenatal and postpartum fever, increased white blood cells or premature rupture of the fetal membrane, etc.), clinical symptoms and signs, changes in peripheral blood signs, and significantly increased C-reactive protein. Confirmation depends on the detection of pathogenic bacteria or pathogenic antigens.

Treatment of neonatal sepsis

Antibiotic treatment

Select sensitive antibiotics based on bacterial culture results and drug sensitivity tests.

Principles of medication: early medication, rational medication, combined medication, intravenous administration. The course of treatment is sufficient, pay attention to the toxic and side effects of the drug.

2. Dealing with serious complications

Monitor blood oxygen and blood gas, timely correct acidosis and hypoxemia, promptly correct shock, and actively deal with cerebral edema and DIC.

3. Clear the infection.

4. Supportive Therapy

Pay attention to heat preservation and supply enough heat and liquid. Correct acidosis and electrolyte disorders.

5. Immunotherapy

Intravenous injection of immunoglobulin.