DOI: 10.36347/sjams.2020.v08i10.010

Pages: 2256-2259

Neonatal sepsis is the most common cause of neonatal mortality and morbidity. Studies have recorded an incidence of neonatal sepsis, varying between 11 and 24.5 per 1000 live births. It is responsible for about 30-50% of the neonatal deaths. Depending on the onset of symptoms, it can be classified into early onset sepsis within 72 h of life and late onset sepsis usually after 72 h of life. It has been one of the major diagnostic problems for physicians due to non-specific symptoms and the absence of a reliable Para clinical marker. The common risk factors for neonatal sepsis include an Apgar score 6 at 5 minutes, prolonged rupture of membranes, placental inflammation, and clinical amnionitis (maternal fever, fetal tachycardia, and amniotic or gastric fluid leukocytes or bacteria), prematurity and very low birth weight, central vascular catheterization, parenteral nutrition, use of broad spectrum antibiotics, H2 blockers and corticosteroids, endotracheal intubation, and prolonged hospital stay. Early signs of sepsis are non-specific and may present with episodes of fever, respiratory distress, diarrhea, low blood sugar level, decreased movements, decreased suckling, seizures, bradycardia, swollen belly area, vomiting, jaundice or rash. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present up to 24 hours before the onset of other signs. Culturing for microorganisms from a sample of CSF, blood or urine, is the gold standard test for definitive diagnosis of neonatal sepsis. Widespread infection despite negative culture is common. In addition to fluid resuscitation and supportive care, a common antibiotic regimen in infants with suspected sepsis is beta-lactam antibiotic in combination with an aminoglycoside or a third generation cephalosporin and organism specific antibiotics. Granulocyte-macrophage colony stimulating factor is sometimes used in neonatal sepsis to correct neutropenia if present but it has no effect on reducing sepsis.