Neonatal Sepsis
Neonatal sepsis is a systemic infection occurring in an infant ≤ 28 days of life. Early identification is critical as it can rapidly progress to septic shock and death.
1. Classification
| Type | Onset | Primary Source |
|---|---|---|
| Early-Onset | ≤ 72 hours of life | Vertical transmission (from mother) |
| Late-Onset | > 72 hours of life | Nosocomial or community-acquired |
2. Clinical Manifestations
- Non-specific: Temperature instability (fever or hypothermia), lethargy, poor feeding, tachycardia, tachypnea, apnea, or abdominal distension.
- Hematological: Neutropenia (often more reliable than leukocytosis) and thrombocytopenia.
3. Management
- Diagnostic Workup: Blood culture (gold standard), CBC, CRP/Procalcitonin, and lumbar puncture (if meningitis is suspected).
- Empirical Antibiotics: Ampicillin + Gentamicin is the standard initial regimen. If hospital-acquired, consider vancomycin or cephalosporins depending on local sensitivity patterns.
- Supportive Care: Fluid resuscitation, oxygenation, and correcting metabolic disturbances (hypoglycemia/acidosis).
NEET PG Hint: Remember the “I/T ratio” (Immature to Total neutrophil ratio); an I/T ratio > 0.2 is a highly sensitive indicator for sepsis. For early-onset sepsis, Group B Streptococcus (GBS) and E. coli are the most common pathogens; for late-onset, consider Staphylococcus epidermidis (especially in neonates with IV lines).