Premium Nahrungsergänzungsmittel | artgerecht

Neonatal Sepsis: Causes, Symptoms & Treatment

Neonatal sepsis is a life-threatening bloodstream infection in newborns. Early diagnosis and prompt treatment are critical for survival and long-term health.

Regular tips about health Regular tips about health

Things worth knowing about "Neonatal sepsis"

Neonatal sepsis is a life-threatening bloodstream infection in newborns. Early diagnosis and prompt treatment are critical for survival and long-term health.

What is Neonatal Sepsis?

Neonatal sepsis is a serious, systemic infection that occurs in newborns during the first four weeks of life. Pathogens – most commonly bacteria, and less frequently viruses or fungi – enter the infant's bloodstream and trigger an overwhelming immune response that can damage vital organs. It is one of the leading causes of death in the newborn period worldwide and requires immediate medical attention.

Causes and Risk Factors

Neonatal sepsis is classified into two main types based on the time of onset:

Early-onset sepsis (EOS): Occurs within the first 72 hours of life. Infection is usually acquired vertically, meaning the infant is exposed to maternal pathogens during pregnancy or delivery. The most common causative organisms are Group B Streptococcus (GBS) and Escherichia coli.
Late-onset sepsis (LOS): Occurs between day 4 and day 90 of life. Infection is often acquired horizontally from the environment, medical devices (e.g., intravenous catheters), or healthcare workers. Common pathogens include Staphylococcus aureus, coagulase-negative staphylococci, and gram-negative rods.

Key risk factors for neonatal sepsis include:

Premature birth and low birth weight
Prolonged rupture of membranes (more than 18 hours before delivery)
Maternal Group B Streptococcus colonization
Maternal fever during labor
Invasive medical procedures (central venous catheters, endotracheal tubes)
Impaired immune function in the newborn

Symptoms

The symptoms of neonatal sepsis are often non-specific and can change rapidly. Parents and medical staff should watch for the following signs:

Behavioral changes: abnormal crying, poor feeding, lethargy, or irritability
Temperature instability: fever (above 38 °C) or hypothermia (below 36.5 °C)
Breathing difficulties: rapid or irregular breathing, apnea (pauses in breathing)
Circulatory changes: pale, gray, or mottled skin, poor perfusion
Neurological signs: seizures, hypotonia (floppy muscle tone)
Abdominal distension, vomiting, or diarrhea
Jaundice that appears suddenly or persists

Diagnosis

Because the symptoms of neonatal sepsis are non-specific, prompt and comprehensive diagnostic evaluation is essential. Typical investigations include:

Blood culture: The gold standard for identifying the causative organism. Blood is tested for bacterial or fungal growth.
Complete blood count (CBC): Changes in white blood cell counts (leukocytosis or leukopenia) may indicate infection.
Inflammatory markers: C-reactive protein (CRP) and procalcitonin (PCT) are important laboratory values for assessing the severity of infection.
Lumbar puncture: Performed when central nervous system involvement (meningitis) is suspected; cerebrospinal fluid (CSF) is examined.
Urine analysis: Particularly relevant in late-onset sepsis.
Imaging: Chest X-ray or ultrasound to assess the lungs, abdomen, and other organs.

Treatment

Treatment of neonatal sepsis is a medical emergency and typically requires admission to a neonatal intensive care unit (NICU). The management includes:

Antibiotic Therapy

As soon as sepsis is suspected, empirical antibiotic therapy is started immediately – even before blood culture results are available. Once the causative organism and its resistance pattern are identified, therapy is adjusted accordingly. A typical first-line regimen is ampicillin combined with an aminoglycoside (e.g., gentamicin).

Supportive Care

Circulatory support: Intravenous fluids and vasopressors if needed to maintain blood pressure
Respiratory support: Supplemental oxygen, CPAP, or mechanical ventilation in cases of respiratory failure
Temperature management: Maintaining warmth or active cooling depending on the clinical situation
Nutritional support: Parenteral nutrition via a vein when oral feeding is not possible

Prevention

To prevent early-onset neonatal sepsis, pregnant women are routinely screened for Group B Streptococcus between weeks 35 and 37 of pregnancy. Women who test positive receive intrapartum antibiotic prophylaxis during labor. Strict hand hygiene when handling newborns is the most important measure for preventing late-onset sepsis.

Prognosis

The prognosis of neonatal sepsis depends critically on the timing of diagnosis and the initiation of treatment. With timely therapy, many newborns recover well. However, long-term complications such as neurological impairment or hearing loss are possible, especially if meningitis occurred or treatment was delayed. Premature infants and those with very low birth weight are at greatest risk for severe outcomes.

References

Stoll BJ et al. - Neonatal Outcomes of Extremely Preterm Infants. JAMA, 2010. Available on PubMed.
Shane AL, Sanchez PJ, Stoll BJ - Neonatal sepsis. The Lancet, 390(10104):1770-1780, 2017.
World Health Organization (WHO) - Pocket Book of Hospital Care for Children, 2nd edition, 2013. Available at: www.who.int

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.