BLOOD INFECTION (Bacterial Sepsis)

Definition: A serious condition caused by multi-plying bacteria in the bloodstream.

1. What caused this condition?

Infections due to bacteria in the bloodstream may occur during the birthing  process  when  bacteria  from  the  birth  canal  get  onto  the newborn’s skin, nose, mouth, and eyes. These bacteria can then get into the lungs and/or bloodstream to cause the infection. Another way that the newborn may become infected is by bacteria infecting  the  placenta  and  getting  into  the  infant’s  bloodstream through the placenta and umbilical cord. The most common bacteria that cause neonatal infections are Group B streptococcus, Listeria mono-cytogenes, and Escherichia coli  (E. coli). Occasionally, viruses such as herpes or cytomegalovirus may also cause infections in the newborn.

2. What problems does it pose?

Infections in newborns can be relatively minor, causing problems such
as mild breathing issues, decreased temperature, or low blood sugar. They  can  also  be  life-threatening  or  fatal,  resulting  in  severe breathing concerns, decreased heart function, and/or seizures.

3. What tests are needed to further define the condition?

The growing of the bacteria or virus on a culture, which is a test performed
by applying samples of the baby’s blood onto a plate with nutrients,
confirms the presence of an infection in the blood. In addition to blood,
samples of the airway secretions; swabs of the eyes, nose, and skin; urine;
and spinal fluid (spinal tap) may also be collected and tested in this manner.

4. How is blood infection treated?

Antibiotics are used to kill the bacteria causing the infection. Some viral infections can be treated with antiviral medications. The laboratory tests (culture) will confirm which medications are most effective in treating the infection. In serious infections, other medications and treatments may be necessary to assist with breathing, to help the heart function properly, and to control seizures.

5. Do we need to consult with a neonatologist (newborn specialist) or an infectious disease specialist?

Very minor or “suspected” infections can be treated by the pediatrician. If the infection is significant or other support is needed, then referral to a neonatologist and/or an infectious disease specialist should occur.

6. How long will it take for my baby to recover from this illness?

Infections  that  are  confirmed  in  the  bloodstream  will  require  a
minimum of seven to fourteen days treatment with intravenous (IV)
antibiotics. If the infection is in the spinal fluid, the antibiotics may be required for up to twenty-one days or more. Depending on the seriousness of the infection, the time for recovery may extend beyond the end of taking antibiotics.

7. Will this condition weaken my baby in any way in the future, and will there be any long-term ill effects caused by it?

In serious infections or infections that involve the spinal fluid or the
brain, there can be long-term effects, such as movement abnormalities,
mental retardation, cerebral palsy, or hearing loss. There may be some
continuing lung abnormalities due to the use of a breathing machine.
Occasionally, the blood infection also infects a joint or bone. This could
result in an injury to that joint or a limitation of the growth of the bone.

8. How long will my baby have to stay in the hospital as a result of this disorder?

At least seven to fourteen days will be required, as the antibiotics to treat the infection have to be given through an IV. In serious infections with complications it may be a month or longer.

9. After discharge from the hospital, what kind of follow-up will be needed?

Infections that did not require significant levels of support other than antibiotics may be monitored under routine care by the pediatrician. If there are complications, especially of the brain and nervous system, developmentalists or neurologists (specialists that monitor the development of the brain) may be recommended.