Sepsis and the Neonatal Patient
By Kim Maryniak, PhD, RNC-NIC, NEA-BC
Sepsis, also known as septicemia, is a toxic condition caused by the spread of invading organisms, or their by-products, through the bloodstream or in other tissue in the body. Sepsis is not just an infection, but includes a spectrum of symptoms of systemic inflammatory response syndrome (SIRS) to septic shock (Anderson, 2015; Caple, 2016).
Neonatal sepsis occurs within the first 30 days of life, although some late-onset sepsis has been described within the first 90 days of life, particularly when related to prematurity (Gardner, Carter, Enzman-Hines, & Hernandez, 2016).
Neonatal sepsis is a significant cause of morbidity and mortality of hospitalized newborns and premature infants. Worldwide, sepsis accounts for 7% of neonatal deaths (Unicef, 2018). In the United States sepsis is the seventh leading cause of neonatal and infant death (Centers for Disease Control and Prevention, 2018). For a neonate, sepsis is the fifth leading cause of death (CDC, 2017). The incidence of neonatal infection is higher for infants with lower gestational age, with premature infants having a three to five times greater risk of developing sepsis.
Neonatal sepsis differs from adult sepsis in terms of risk factors, symptoms, diagnosis and treatment, and continues to have a high rate of morbidity and mortality for infants. Causes of sepsis may be from viral, fungal, bacterial or parasitic sources. Risk factors for developing neonatal sepsis may include those which are maternal, neonatal, and environmental. Diagnosing sepsis may involve multiple tests. Nurses are essential in identifying symptoms of sepsis and in the treatment of the neonate with suspected or confirmed infection. There are multiple nursing management considerations for these patients.
For more information about neonatal sepsis, see the RN.com course Neonatal Sepsis: Assessment and Care.
Anderson, A. (2015). Neonatal sepsis. Retrieved from http://emedicine.medscape.com/article/978352-overview
Caple, C. (2016). Sepsis, neonatal: Identifying and managing. Glendale, CA: Cinahl Information Systems.
Centers for Disease Control and Prevention. (2017). Mortality in the United States, 2016. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db293.htm
Centers for Disease Control and Prevention. (2018). Deaths: Leading causes for 2016. National Vital Statistics Reports. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_06.pdf
Gardner, S.L, Carter, B.S., Enzman-Hines, M. & Hernandez, J. (2016). Merenstein & Gardner's handbook of neonatal intensive care (8th ed.). St. Louis, MO: Mosby Elsevier.
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