Assessment for newborns sepsis and workup Veronica Dixon

Assessment for newborn’s sepsis and workup • Veronica Dixon • Mercy College

What is sepsis? • Sepsis is the manifestation of harmful bacteria and toxins in the body which if left untreated can lead to blood poisoning and ultimately death. • Sepsis can be presented in the amniotic fluid or in the vagina of a pregnant woman. • Before a woman goes into labor her vagina is swabbed for colonization of Group Beta Strep (GBS)

Warning signs of neonatal sepsis • Some of the most prominent warning signs of sepsis in a neonate is tachycardia, tachypnea, decrease temperature ˂ 36. 5 degrees, grunting or retracting, hypotonia, Respiratory Distress Syndrome (RDS) and persistent hypoglycemia. Symptoms can be presented in one condition as well as in combined conditions.

Automatic workup for neonatal sepsis • Group Beta Streptococcus is present in the female reproductive tract and can be spread to the neonate before or throughout delivery. • If GBS is positive and wasn’t treated the neonate has to checked for sepsis. • If mom’s amniotic fluid sac was ruptured for more than 18 hours that is also an automatic workup for the neonate. This is call chorioamnionitis. • If mom comes to the labor and delivery unit fully or almost dilated “in labor” and her GBS status was undetermined the neonate has to be worked up for sepsis.

No need for sepsis workup • If the mother’s GBS is positive and she was adequately treated with a form of antibiotic before delivering the baby, then there’s no need for a sepsis workup on the neonate unless other symptoms of sepsis is manifested.

Algorithm for sepsis workup blood culture is sent to the lab antibiotic is started, usually ampicillin and penicillin CPR, CBC with diff is sent to the lab 6 -12 hrs after delivery to check the level (if any signs) of sepsis

CBC results • CBC is checked for Immature Neutrophil Count ( I: T) level should be ˂. 20 , C-Reactive Protein (CRP) level ˂ 0. 5 • If the I: T level is more than the above value the neonate is will continue antibiotic for 7 days.