Sepsis is dangerous, no matter how old you are. Newborns with sepsis, however, are at a particularly high mortality risk. This is because their immune systems are not yet well-developed. In recent years, doctors have reported an increased struggle with Neonatal sepsis as antibiotic resistance continues to rise. This blood infection is now killing more newborn babies than ever before.
What is Neonatal Sepsis?
Neonatal sepsis is a serious medical condition that affects newborn babies. It is a bloodstream infection that can be caused by bacteria, viruses, or fungi. It is estimated that neonatal sepsis affects around 3-4 million newborns globally, and it is responsible for at least 200,000 deaths each year. (1) Antibiotics are the primary treatment for neonatal sepsis. However, the increasing prevalence of antibiotic-resistant bacteria is making it difficult to treat this condition. Antibiotic resistance is a major global health threat, and it is estimated that by 2050, it could be responsible for 10 million deaths annually. (2)
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Causes of Neonatal Sepsis
Neonatal sepsis can be caused by a variety of microorganisms, including bacteria, viruses, and fungi. The most common bacteria that cause neonatal sepsis are Group B Streptococcus (GBS), Escherichia coli (E. coli), and Klebsiella. The prevalence of newborn sepsis caused by GBS, however, has decreased because women are now screened for it during pregnancy. (3) Newborns are particularly vulnerable to infections because their immune systems are not fully developed. They are also at risk of infection during delivery, especially if the mother has an infection.
Signs and Symptoms of Neonatal Sepsis
The signs and symptoms of neonatal sepsis can vary depending on the infection type and the baby’s age. In general, the symptoms include (4):
- Fever or low body temperature
- Poor feeding or lack of appetite
- Lethargy or irritability
- Rapid breathing or difficulty breathing
- Jaundice (yellowing of the skin and eyes)
- Skin rash or redness
- Swelling or inflammation
Diagnosis and Treatment
Diagnosing neonatal sepsis can be challenging because the symptoms can be similar to other conditions. Doctors will typically perform blood tests and other diagnostic tests to determine if the baby has an infection. The primary treatment for neonatal sepsis is antibiotics. However, the choice of antibiotic will depend on the type of infection and the bacteria causing it. In some cases, a combination of antibiotics may be necessary.
Antibiotic Resistance
Antibiotic resistance occurs when bacteria develop the ability to resist the effects of antibiotics. This can happen when antibiotics are overused or misused, allowing bacteria to mutate and develop resistance. Antibiotic-resistant bacteria are becoming more common, and they are a major concern for healthcare professionals. They are particularly dangerous for newborns, who have weaker immune systems and are more vulnerable to infections. Recently, a team of 80 researchers from four continents has been studying this issue and newborn sepsis in 19 hospitals. They studied babies from 2018 to 2020 in 11 countries: Bangladesh, Brazil, China, Greece, India, Italy, Kenya, South Africa, Thailand, Vietnam and Uganda. The results confirmed their fears: Deaths from newborn sepsis were on the rise as antibiotics function less and less.
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Their findings were recently published in PLOS Medicine (5).
“It was very important to undertake this study to get a better understanding of the kind of infections we’re seeing in newborns in hospitals, the bugs causing them, the treatments that are being used and why we are seeing more deaths,” said Manica Balasegaram, executive director of the Global Antibiotic Research and Development Partnership (GARDP). “The study has given us vital information which will help us to better design clinical trials and ultimately improve the care and outcome of babies with neonatal sepsis,”
The team developed two tools that could be used in clinical trials and in any neonatal intensive care unit worldwide. Their goal is to help physicians identify babies that are at risk of dying faster. This way, they can receive treatment before it’s too late. They also hope to inform WHO guidelines of treatment for newborns with sepsis.
Prevention
Of course, prevention is always key. With newborn sepsis, this comes in a few facts: Preventing infections from happening in the first place and putting a stop to antibiotic resistance. Preventing neonatal sepsis involves a combination of measures, including:
- Screening pregnant women for infections that can cause neonatal sepsis, such as GBS
- Administering antibiotics during labor to women who test positive for GBS
- Proper hand hygiene and infection control measures in hospitals and clinics
- Avoiding unnecessary use of antibiotics
The Bottom Line
Neonatal sepsis is a serious medical condition that can be difficult to treat, especially in the face of antibiotic resistance. Healthcare professionals and policymakers must work together to prevent neonatal sepsis and reduce the prevalence of antibiotic-resistant bacteria. By taking a comprehensive approach to prevention and treatment, we can save countless newborn lives and protect the health of future generations.
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Sources
- “Global Study highlights newborn death from sepsis and burden of antibiotic resistance. St. George’s University of London. June 8, 2023
- “Antimicrobial resistance: a global threat.” UNEP
- “Neonatal sepsis.” Medline Plus
- “Patterns of antibiotic use, pathogens, and prediction of mortality in hospitalized neonates and young infants with sepsis: A global neonatal sepsis observational cohort study (NeoOBS).” Journals. Neal J. Russell, et al. June 8, 2023