Septicemia neonatorum, or neonatal sepsis, is a generalized bloodstream infection in newborns that is commonly caused by various gram-positive and gram-negative bacteria. It can occur when a neonate's immune system is temporarily weakened. Predisposing factors include maternal complications, prematurity, and iatrogenic causes such as medical procedures. Early signs are vague but include poor feeding, temperature changes, and lethargy. Treatment involves diagnostic tests, antibiotics targeted at common causes, and supportive care; complications can include meningitis, shock, and organ damage.

1. Septicemia
Neonatorum
Hannilore Villamor, RN

2. Septicemia neonatorum
• Sepsis of the neonate
• A generalized infection
• Characterized by the proliferation of
bacteria in the bloodstream and
commonly involves the meninges
• High mortality

3. PATHOPHYSIOLOGY AND
ETIOLOGY

4. Etiologic Agents
• Gram-negative organisms
o Escherichia coli
o Klebsiella (Enterobacteriaceae)
o Pseudomonas
o Proteus
o Salmonella
o Hemophilus influenzae

5. • Gram-positive organisms
o group B beta-hemolytic
Streptococcus
o Listeria monocytogenes
o Staphylococcus aureus
(coagulase-negative and
coagulase-positive)
o Staphylococcus epidermidis
o Streptococcus pneumoniae
o Streptococcus faecalis

6. • Fungal infections from the organism
Candida albicans are increasing in
incidence, especially in the low-
birth-weight neonate
• Infection occurs because of a
temporary breakdown or depression
of the neonate's defense mechanism
for an unknown reason

7. Predisposing factors
• Wide range of maternal perinatal
complications
• Iatrogenic factors
o Use of catheters, oxygen,
resuscitative equipment
• Infant complications
o Prematurity, congenital
anomalies, RDS, skin infections,
asphyxia

8. NURSING ASSESSMENT AND
INTERVENTIONS

9. • Be alert for early signs of sepsis,
which are usually vague and subtle
o Poor feeding; gastric retention;
weak sucking
o Lethargy, limpness; weak crying.
o Temperature alteration—
generally hypothermia, but infant
may have hyperthermia
o Hypoglycemia or hyperglycemia

10. • Assist with diagnostic tests.
o Cultures from the blood, urine,
spinal fluid, skin lesions, nose,
throat, rectum, gastric fluid.
o WBC and differential,
hemoglobin, hematocrit.
o Blood chemistries—glucose,
calcium, pH, electrolytes.

11. o C-reactive protein and erythrocyte
sedimentation rate.
o Acid-base studies (acidosis).
o Bilirubin.
o TORCH (toxoplasmosis-rubella-
cytomegalic inclusion virus-
herpes-other) detects antibodies
against common intrauterine-
infective agents.

12. o ABG values.
o Chest X-ray—may demonstrate
pulmonary infection.
o Urinalysis.

13. • Assist with treatment.
o Before the specific organism is
identified, and after cultures have
been obtained, the antibacterial
therapy is based on the more
common causative agents and
their anticipated susceptibilities.

14. o Supportive therapy includes:
observation, isolation, hydration,
nutrition, oxygen, regulation of
thermal environment, blood
transfusion to correct anemia and
shock, and protection from
further infection.

15. • Observe for complications:
o Meningitis (very common)
o Shock
o adrenal hemorrhage
o disseminated intravascular coagulation
o PPHN
o metabolic derangements
o Seizures
o Pneumonia
o UTI
o heart failure