Site Map

Neonatal sepsis

Sepsis neonatorum; Neonatal septicemia; Sepsis - infant

Neonatal sepsis is a blood infection that occurs in an infant younger than 90 days old. Early-onset sepsis is seen in the first week of life. Late onset sepsis occurs after 1 week through 3 months of age.

Causes

Neonatal sepsis can be caused by bacteria such as Escherichia coli (E coli), Listeria, and some strains of streptococcus. Group B streptococcus (GBS) has been a major cause of neonatal sepsis. However, this problem has become less common because women are screened during pregnancy. The herpes simplex virus (HSV) can also cause a severe infection in a newborn baby. This happens most often when the mother is newly infected.

Early-onset neonatal sepsis most often appears within 24 to 48 hours of birth. The baby gets the infection from the mother before or during delivery. The following increase an infant's risk of early-onset bacterial sepsis:

Babies with late-onset neonatal sepsis are infected after delivery. The following increase an infant's risk for sepsis after delivery:

Symptoms

Infants with neonatal sepsis may have the following symptoms:

Exams and Tests

Lab tests can help diagnose neonatal sepsis and identify the cause of the infection. Blood tests may include:

If a baby has symptoms of sepsis, a lumbar puncture (spinal tap) will be done to look at the spinal fluid for bacteria. Skin, stool, and urine cultures may be done for herpes virus, especially if the mother has a history of infection.

A chest x-ray will be done if the baby has a cough or problems breathing.

Urine culture tests are done in babies older than a few days.

Treatment

Babies younger than 4 weeks old who have fever or other signs of infection are started on intravenous (IV) antibiotics right away. (It may take 24 to 72 hours to get lab results.) Newborns whose mothers had chorioamnionitis or who may be at high risk for other reasons will also get IV antibiotics at first, even if they have no symptoms.

The baby will get antibiotics for up to 3 weeks if bacteria are found in the blood or spinal fluid. Treatment will be shorter if no bacteria are found.

An antiviral medicine called acyclovir will be used for infections that may be caused by HSV. Older babies who have normal lab results and have only a fever may not be given antibiotics. Instead, the child may be able to leave the hospital and come back for checkups.

Babies who need treatment and have already gone home after birth will most often be admitted to the hospital for monitoring.

Outlook (Prognosis)

Many babies with bacterial infections will recover completely and have no other problems. However, neonatal sepsis is a leading cause of infant death. The more quickly an infant gets treatment, the better the outcome.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Seek medical help right away for an infant that shows symptoms of neonatal sepsis.

Prevention

Pregnant women may need preventive antibiotics if they have:

Other things that can help prevent sepsis include:

References

Esper F. Postnatal bacterial infections. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 48.

Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal morbidities of prenatal and perinatal origin. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 73.

Korang SK, Safi S, Nava C, et al. Antibiotic regimens for early-onset neonatal sepsis. Cochrane Database Syst Rev. 2021;5(5):CD013837. PMID: 33998666 pubmed.ncbi.nlm.nih.gov/33998666/.

Polin R, Randis TM. Perinatal infections and chorioamnionitis. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 25.

Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion Summary, Number 797. Obstet Gynecol. 2020;135(2):489-492. PMID: 31977793 pubmed.ncbi.nlm.nih.gov/31977793/.

BACK TO TOP

Review Date: 5/24/2021  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

ADAM Quality Logo

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2022 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.