Sepsis in Neonates: Key Points for Nursing Students
Definition and Causes
Neonatal sepsis is a systemic infection occurring in infants within the first 90 days of life. It can be categorized into:
• Early-onset sepsis (EOS): Occurs within the first 72 hours of life, often caused by pathogens from the maternal genital tract, such as Group B Streptococcus (GBS) and Escherichia coli.
• Late-onset sepsis (LOS): Occurs after 72 hours, typically due to environmental pathogens like Staphylococcus aureus or Candida species【8】【10】.
Clinical Signs
• Temperature instability (hypothermia or hyperthermia)
• Poor feeding and lethargy
• Respiratory distress, tachypnea, or apnea
• Jaundice, irritability, and abnormal cry
• Hypotension and signs of poor perfusion (cold extremities, delayed capillary refill)
Diagnosis
• Blood cultures and lumbar puncture (to rule out meningitis)
• Complete blood count (CBC) with differential
• C-reactive protein (CRP) and procalcitonin levels as inflammatory markers
• Chest X-ray and other imaging if respiratory or focal infection is suspected【8】【9】.
Management
• Empiric antibiotic therapy should begin immediately upon suspicion of sepsis. Common regimens include ampicillin and gentamicin.
• Supportive care, including fluid management, oxygen, and monitoring for complications, is essential.
• Close monitoring of blood glucose and electrolytes is also crucial in neonatal care【9】【10】.
Prevention
• Maternal screening and treatment for GBS during pregnancy can significantly reduce early-onset sepsis.
• Adhering to infection control protocols in neonatal units is critical for preventing late-onset sepsis【8】.
Citation:
Agency for Healthcare Research and Quality (AHRQ). “Best Practices in the Diagnosis and Treatment of Sepsis.” Available at: AHRQ.gov
MedlinePlus. “Neonatal Sepsis.” NIH MedlinePlus Magazine. Available at: MedlinePlus【8】【10】.