Hello everybody, today I am going to talk about sepsis in newborn. Sepsis means infection in the blood. Infection means invasion of disease causing organisms into the tissues of the body. There are millions of bacteria in a healthy individual in various parts of the body. They do not cause any illness, unless the individual lacks the strength to fight the infection, which is called as immunity. Harmful organisms enter the human body through various means like breathing that is air entering through the nose, eating that through the mouth and contact that is with the skin. There are barriers in each of these areas to stop the organisms entering into the body. Mouth has enzymes, which kills the organisms, the nose produces warmth that is humidity and mucus, which traps the organisms and particles which can enter into the body. Skin is the largest and very important protective organ for the entire body. Any breach in these barriers will allow the harmful organisms to enter the body and cause the disease. If the organisms manage to breakthrough these barriers and enter the body, the body produces lots of chemical substances, which might contain engulfed organisms or excrete organisms. In these processes, the chemical substances might increase the body temperature, which is called as fever or send lots of fluids into the area of the infection, which could result in swelling or edema of that area of the body. Or the white cells, which are called as policemen of the body might kill or engulf these organisms and excrete them. Newborns are at a much higher risk of infection even before the delivery itself, where the infection might come either through the blood of the mother that is blood stream infection or something called as ascending infection, where the infection spreads from the birth canal. Hence, pregnant women should take at most care in maintaining the personal hygiene. After the birth the newborn infants, especially the preterm infants, have a defective barrier that we just discussed. For example, the preterm infants or dependent on the tube feeding that is a tube that is passed bypassing the mouth into the stomach. Hence, the mouth barrier is broken. They are dependent on breathing support, where we put the tube directly into the lungs to give the oxygen and air. This bypasses the upper airway defensive mechanisms. And the biggest problem which is the immaturity of the skin in preterm infants, leads to an easy entry of harmful organisms into the body. More or so because they are dependent on intravenous fluid, which breaks the barrier in the skin where the organisms can easily enter. Any of these organisms, once they enter into the premature body, the internal immunity responses are very poor as well. This leads to spreading of the infections throughout the body. One of the commonest causes of death in premature infants is infection. Hence, prompt recognition and treatment with antibiotics will be essential. Doctors might do several investigations to find out where the infection is and also to see where the infection is spreading. This might include different types of blood tests, chest x-ray and also a procedure called as lumbar puncture, where the fluid is tested in the backbone which might indicate whether there is an infection surrounding the brain or not. Depending on the site of the infection, the duration of the antibiotics might range from 10 days to even 3 weeks. Unless, this infection is completely cleared, they can resurface again. Hence, a complete course of antibiotics is essential. Prevention of these infections entering into the premature infants is the most important mechanism through which we can reduce the infection.
Pregnant women should take care of the personal hygiene. Also, when they visit the hospitals or clinics, ensure that they washed their hands once they return back home as infections can spread from instruments or contact surface areas. After delivery of the premature infant, it is essential that mothers try to express the initial breast milk, which is called as colostrum, which is very rich in anti-infective substances. The more the breast milk that the newborns receive, the less infections will be seen. This also is helped by the early establishment of the feeds, hence, less requirement of intravenous fluid and breaching the barriers of the skin. Also, skin to skin contact in premature infants with mother helps mother producing the anti-infective substances which gets excreted in the milk and the newborn can have those properties. Hence, prevention of the infection and treating it appropriately would be the key to prevent the complications from sepsis in newborn infants.
Team Ovum Hospitals