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Neonatal Sepsis
Neonatal Sepsis
Njiraini
Neonatal sepsis (NS)
• Neonatal sepsis (NS) is defined as clinical
syndrome of bacteremia with systemic signs
and symptoms of infection in the first four
weeks of life.
ETIOLOGY
• Common organisms identified:
• 1. Escherichia coli.
• 2. Group B Streptococci.
• 3. Listeria monocytogenes.
4.Others:
Coagulase negative staphylococci.
Streptococcus pneumoniae.
Klebsiella pneumoniae.
Acinetobacter species.
Pseudomonas aeruginosa.
Candida.
EPIDEMIOLOG
Y
• Incidence: 1-8 cases per 1,000 live births.
• Mortality: 13-70% world wide.
• 13-15% of all neonatal deaths (USA)
(8 th cause).
• Sex: Males > Females.
• Age: premature infants
Pathogenesis
• Neonatal infections are unique in several ways:
1. Infectious agents can be transmitted from the mother to the fetus or newborn infant by
diverse modes.
2. Newborn infants are less capable of responding to infection because of 1 or more
immunologic deficiencies.
3. Coexisting conditions often complicate the diagnosis and management of neonatal
infections.
4. The clinical manifestations of newborn infections vary and include subclinical infection,
mild to severe manifestations of focal or systemic infection, and, rarely, congenital
syndromes resulting from in utero infection. The timing of exposure, inoculum size, immune
status, and virulence of the etiologic agent influence the expression of disease.
5. Maternal infection that is the source of transplacental fetal infection is often undiagnosed
during pregnancy because the mother was either asymptomatic or had nonspecific signs
and symptoms at the time of acute infection.
6. A wide variety of etiologic agents infect the newborn, including bacteria, viruses, fungi,
protozoa, and mycoplasmas.
7. Immature, very low birthweight (VLBW) newborns have improved survival but remain in the
hospital for a long time in an environment that puts them at continuous risk for acquired
infections.
Classification
• Neonatal sepsis include the following:
• Congenital infection —major risk factor is maternal
infection.
Early-onset sepsis (birth to 7 days)—transplacental,
ascending, or intrapartum.
manifests as: 1. Pneumonia (Frequently) 2. Less commonly
as: • Septicemia. • Meningitis.
Late-onset sepsis (8 to 28 days)—acquired in hospital,
home, or community
manifests as: 1.Septicemia. 2.hematogenous seeding may
result in focal infections, such as meningitis (in 75% of
cases), osteomyelitis (group B streptococci, S. aureus),
arthritis (gonococcus, S. aureus, Candida albicans, gram-
negative bacteria), and urinary tract infection (gram-
negative bacteria).
Early Versus Late Neonatal Sepsis