Abby

I.INTRODUCTION SEPSIS in a newborn (sepsis neonatorum) is an infection that spreads throughout the baby’s body. Sepsis occurs in less than 1 percent of newborns (1 out of every 100), but accounts for up to 30 percent of deaths in the first few weeks of life. Infection is 5-10 times more common in premature newborns and in babies weighing less than 5½ pounds than in normal-weight, full-term newborns. Complications experienced during birth, such as premature or prolonged rupture of the membranes or infection in the mother, put the newborn at increased risk of infection. There are two types of sepsis neonatorum. Early sepsis (less than 3 days) is acquired in the perinatal period; infection can occur from direct contact with organisms from the maternal gastrointestinal and genitourinary tracts. The most common infecting organism are group B streptococcus and scherichia coli, which may present in the vagina. Late sepsis (1 to 3 weeks after birth is primarily nosocomial, and the offending organisms are usually staphylococci,klebsiella and pseudomonas. Babies can also develop sepsis by contracting infections after birth from infected persons or objects. Babies in the newborn intensive care unit (NICU) are at increased risk for acquiring nosocomial (hospital-acquired) infections. Many babies in the NICU are premature or have low birthweight which makes them more susceptible to infection and more likely to need invasive treatments and procedures. Microorganisms that normally live on the skin may cause infection if they enter the body through catheters and other tubes inserted into the baby's body.

A.PREDISPOSING FACTORS *(Pregnancy Complications) •

premature rupture of the membranes (amniotic sac), or membrane rupture for an extended length of time

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bleeding problems

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a difficult delivery

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infection in the uterus or placental tissues

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fever in the mother

*(Nosocomial) • •

unsterile instruments personnel or staff in the hospital

B.ETIOLOGY 1. All neonatal infections are considered opportunistic, and all bacteria are capable of causing sepsis. 2. Group B streptococcus is the most cause. • • •

Group A streptococcus E.coli Strep.viridans

C. SIGNS AND SYMPTOMS *Initial signs and symptoms • • • •

Poor sucking and feeding Weak cry Lethargy Irritability

*Subsequent signs and symptoms • •

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Pallor, cyanosis, mottling Deacresed pain response Hypotension Jaundice Irreg.respiration Dehydration

D. DEFINITION OF TERMS Sepsis or septicemia- refers to generalized bacterial infection in the bloodstream Nosocomial Infection- infection acquired in the hospital Lethargy- the quality or state of being drowsy and dull, listless and unenergetic, or indifferent and lazy; apathetic or sluggish inactivity.

E. HOW IS SEPSIS DIAGNOSED? A sepsis workup may be needed to help identify the location of the infection and type of microorganism causing the infection. A sepsis workup may include the following procedures: •

blood tests

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lumbar puncture (Also called spinal tap.) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.

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blood cultures

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urine culture (sometimes by suprapubic tap, insertion of a needle through the lower abdomen into the bladder)

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culture of fluids from inside tubes and catheters that are inserted in the baby

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x-rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. Procedures may also be performed to determine which antibiotics or medications are most effective for treating the specific microorganism.