The Indian Journal of Pediatrics

, Volume 68, Issue 12, pp 1143–1147 | Cite as

Sepsis in the newborn

  • Rajiv Aggarwal
  • Nupur Sarkar
  • Ashok K. Deorari
  • Vinod K. Paul
AIIMS Protocols in Neonatology-II


Systemic infection in the newborn is the commonest cause of neonatal mortality. Data from National Neonatal Perinatal Database 2000 suggest thatKlebsiella pneumoniae andStaphylococcus aureus are the commonest causes of neonatal sepsis in India. Two forms of clinical presentations have been identified. Early onset sepsis, probably related to perinatal risk factors, usually presents with respiratory distress and pneumonia whthin 72 hours of age. Late onset sepsis, related to hospital acquired infections, usually presents with septicemia and pneumonia after 72 hours of age. Clinical features of sepsis are non-specific in neonates and a high index of suspicion is required for the timely diagnosis of sepsis. Although blood culture is the gold standard for the diagnosis of sepsis, reports are available after 48–72 hours. A practical septic screen for the diagnosis of sepsis has been described and some suggestions for antibiotic use have been included in the protocols.

Key words

Sepsis Neonatal mortality Risk factors 


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  1. 1.
    Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India.Lancet 1999; 354: 1955–1961.PubMedCrossRefGoogle Scholar
  2. 2.
    Stall BJ. The global impact of neonatal infection.Clin Perinatol 1997; 24:1–21.Google Scholar
  3. 3.
    Report of the National Neonatal Perinatal Database (National Neonatology Forum) 2000.Google Scholar
  4. 4.
    Kaftan H, Kinney JS. Early onset neonatal bacterial infections.Semin Perinatol 1998; 22: 15–24.PubMedCrossRefGoogle Scholar
  5. 5.
    Belady PH, Farkouh LJ, Gibbs RS. Intra-amniotic infection and premature rupture of membranes.Clin Perinatol 1997; 24: 43–57.PubMedGoogle Scholar
  6. 6.
    Baltimore RS. Neonatal nosocomial infections.Semin Perinatol 1998; 22: 25–32.PubMedCrossRefGoogle Scholar
  7. 7.
    Wolach B. Neonatal sepsis: pathogenesis and supportive therapy.Semin Perinatol 1997; 21: 28–38.PubMedCrossRefGoogle Scholar
  8. 8.
    Gerdes JS, Polin R. Early diagnosis and treatment of neonatal sepsis.Indian J Pediatr 1998; 65: 63–78.PubMedGoogle Scholar
  9. 9.
    Polinski C. The value of white blood cell count and differential in the prediction of neonatal sepsis.Neonatal Netw 1996; 15: 13–23.Google Scholar
  10. 10.
    Da Silva O, Ohlsson A, Kenyon C. Accuracy of leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis: a critical review.Pediatr Infect Dis J 1995; 14:362–366.CrossRefGoogle Scholar
  11. 11.
    Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The neonatal blood count in health and disease. I.Refernce values for neutrophilic cells.J Pediatr 1979; 95: 89–98.PubMedCrossRefGoogle Scholar
  12. 12.
    Sarff LD, Platt LH, McCracken GH Jr. Cerebrospinal fluid evaluation in neonates: Comparison of high-risk neonates with and without meningitis.J Pediatr 1976; 88 : 473–477.PubMedCrossRefGoogle Scholar
  13. 13.
    Sadana S, Mathur NB, Thakur A. Exchange transfusion in septic neonates with sclerema: effect on immunoglobulin and complement levels.Indian Pediatr 1997; 34: 20–25.PubMedGoogle Scholar
  14. 14.
    Jenson HB, Pollock HB. The role of intravenous immunoglobulin for the prevention and treatment of neonatal sepsis.Semin Perinatol 1998; 22: 50–63.PubMedCrossRefGoogle Scholar
  15. 15.
    Goldman S, Ellis R, Dhar V, Cairo MS. Rationale and potential use of cytokines in the prevention and treatment of neonatal sepsis.Clin Perinatol 1998; 25: 699–710.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2001

Authors and Affiliations

  • Rajiv Aggarwal
    • 1
  • Nupur Sarkar
    • 1
  • Ashok K. Deorari
    • 1
  • Vinod K. Paul
    • 1
  1. 1.Division of Neonatology, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia

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