Neonatal Septicaemia

​Neonatal septicaemia is a potentially life-threatening bloodstream and systemic infection that occurs during the neonatal period. It is caused by micro-organisms that may be passed to the baby from a mother’s birth canal in the immediate newborn period or from the surrounding environment a few days after birth. 

​Symptoms of sepsis may be non-specific and are usually related to the site of infection, the nature of the causative micro-organism and the body’s response to the infection. Common symptoms include lethargy, poor feeding, difficult or fast breathing, fast heart rate, a bluish or pale discolouration of the skin, vomiting and fever. 

​Risk factors for neonatal sepsis include prematurity, prolonged rupture of a mother’s water bag beyond 18 hours, maternal infection such as chorioamnionitis and maternal carriage of group B streptococcus within the birth canal. Methods of decreasing risk of neonatal sepsis include administration of antibiotics to mothers with the above-mentioned risk factors or facilitating delivery of a baby if a pregnant mother has chorioamnionitis. It is also very important to maintain safe practices such as hand washing before touching baby, ensure a clean environment around the baby and take precautionary measures such as restricting visiting access if someone is not well and wishes to see the baby. 

​Diagnosis is made on the basis of history, physical examination and investigations including analysis of blood, urine, cerebrospinal fluid or chest or abdominal X-rays and other imaging modalities. 

​The primary treatment for neonatal sepsis is the timely use of appropriate antibiotics for a sufficient duration of time, elimination of the source of infection and supportive treatment as required. Other measures may y include respiratory support (with oxygen therapy, CPAP or mechanical ventilation), nutritional support (with intravenous dextrose and hydration or total parenteral nutrition) and support of blood pressure.