Sepsis or Septic Shock

What is sepsis?

Sepsis is a term for severe infection that is present in the blood and spreads throughout the body. In newborns, it is also called sepsis neonatorum or neonatal septicemia.

Prevention & Risk Treatment

Prevention & Risk Treatment

What causes sepsis?

Sepsis can develop following infection by microorganisms including bacteria, viruses, fungi, and parasites. Infection in babies can be contracted during pregnancy, from the mother's genital tract during labor and delivery, or after birth from contact with others.

Sepsis in a newborn is more likely to develop when the mother has had pregnancy complications that increase the likelihood of infection. Such complications may include the following:

  • Premature rupture of the membranes (amniotic sac), or membrane rupture for an extended length of time
  • Bleeding problems
  • A difficult delivery
  • Infection in the uterus or placental tissues
  • Fever in the mother

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.

What microorganisms cause severe infections and sepsis in babies?

Prenatal During Delivery After Birth

Listeria monocytogenes

Group B streptococcus (GBS)

Respiratory syncytial virus (RSV)

E. coli

Candida

Herpes simplex virus

Haemaphilius influenzae type b (Hib)



Enterovirus

Why is sepsis a concern?

Sepsis can be life-threatening for newborns, especially if the baby has a weakened immune system because of prematurity or another illness. When a baby's immature immune system cannot fight the microorganism, the infection can quickly spread and overtake the body, causing serious illnesses such as meningitis or pneumonia.

What are the symptoms of sepsis?

Sepsis in newborns is not always easy to identify since newborn babies often do not show symptoms of infections in the same way older babies and children may show symptoms. The following are some of the symptoms of infection in newborn babies. However, each baby may experience symptoms differently depending on the type of organism causing the infection and the severity and location of the infection. Symptoms of infection may include the following:

  • Apnea (stopping breathing) or difficulty breathing
  • Bradycardia (decreased heart rate)
  • Decreased temperature or temperature instability
  • Weak suck
  • Pale or mottled coloring or jaundice (yellow coloring of the skin and eyes)
Diagnosis

Diagnosis

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
  • Lumbar puncture (also called spinal tap). This is 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.
  • Blood cultures
  • Urine culture. This may be obtained with a catheter or sometimes by suprapubic tap, insertion of a needle through the lower abdomen into the bladder. 
  • Culture of fluids from inside tubes and catheters that are inserted in the baby
  • X-rays. This is a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

Procedures may also be done to determine which antibiotics or medications are most effective for treating the specific microorganism.

Children's Team

Children's Team

Providers

Departments

Departments

Critical Care Medicine

With the only pediatric, cardiac, and neuro intensive care units in the immediate Washington, DC, area, Children’s National Health System is the region’s leading provider of critical care medicine for seriously ill and injured infants and children.

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Cameron's Story

Patient story

"I hope this letter gives hope to other parents that may be in this same situation. Early diagnosis is the key."

Read More of Cameron's Story