Neonatal sepsis

Karolina Stankevičiūtė1, Diana Daščioraitė1, Deividas Rimkus1 

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Introduction: Neonatal sepsis can be classified into early onset and late onset, which varies according to the methods of acquisition and the time of onset. Early onset sepsis is the result of vertical bacterial transmission from the mother during the perinatal period. The fetus can be contaminated with bacteria as they rise from the vagina into the uterus, hematologically through the placenta, or in rare cases through the fallopian tube. Late onset sepsis is caused by exposure to pathogenic bacteria in the postnatal environment.

Objective: To elucidate neonatal sepsis description, risk factors, diagnostic methods and treatment.

Methods: Based on publications found by “Pubmed” published in 2010-2020, a literature review was performed.

Results: The risk of sepsis is increased by preterm birth, low birth weight, long anhydrous period, chorioamnionitis, long hospitalization time, vitamin D deficiency, maternal group β hemolytic B streptococcal colonization. The disease is diagnosed on the basis of clinical signs and laboratory data. Laboratory assessment includes a complete blood count, C-reactive protein and procalcitonin levels. The most important test is the blood culture. Early initiation of treatment is very important when neonatal sepsis is diagnosed. The two most important components of treatment are supportive treatment and rational antimicrobial therapy. The recommended empirical treatment for suspected neonatal sepsis is a combination of ampicillin and gentamicin.

Conclusions: Neonatal sepsis is an important cause of morbidity and mortality among newborns.  Diagnosis can be difficult because the first symptoms are mild and begin in a variety of ways. Once the disease has been diagnosed, a blood culture should be performed as soon as possible also supportive treatment and empirical antibiotic therapy should be initiated. Once the pathogens have been identified and their susceptibilities known the most appropriate antimicrobial should be administered.


Keywords: neonatal sepsis, infection, antibiotics.