Late-onset sepsis (LOS), defined as sepsis onset after 72 h of life, is a leading cause of mortality in the neonatal intensive care unit (NICU) [1]. The incidence rates for LOS in preterm infants vary between 20 and 38% in the first 120 days of life, and mortality rates range from 13 to 19% [1-4].
Neonatal sepsis is a blood infection that occurs in an infant younger than 90 days old. Early-onset sepsis is seen in the first week of life. Late onset sepsis occurs after 1 week through 3 months of age.
Early-onset sepsis (EOS) is defined as onset of features of sepsis within 72 hrs of life while Late-onset sepsis (LOS) is defined as onset of features of sepsis after 72hrs of life.
Bacteria such as E. coli, Listeria and Group B streptococcus (GBS) are common bacteria that can cause infections that lead to sepsis. Viruses, fungi and parasites can also lead to the condition. For instance, the herpes simplex virus (HSV) can cause severe infections in newborns.
a high temperature (fever) or low body temperature. a change in mental state – like confusion or disorientation. slurred speech. cold, clammy and pale or mottled skin.
Sepsis can develop quickly from initial infection and progress to septic shock in as little as 12 to 24 hours. 1 You may have an infection that's not improving or you could even be sick without realizing it.
Risk factors include low birth weight, low gestational age, previous antimicrobial exposure, poor hand hygiene, and central venous catheters.
Many clinicians consider sepsis to have three stages, starting with sepsis and progressing to severe sepsis and septic shock. Septic shock is the most serious stage and presents patients with the worst survivability odds, some as high as 50% mortality.
The condition can arise suddenly and progress quickly, and it's often hard to recognize. Sepsis was once commonly known as “blood poisoning.” It was almost always deadly. Today, even with early treatment, sepsis kills about 1 in 5 affected people.
For example, the “golden hour” as applied to the treatment of critically children and adults with severe sepsis and septic shock is based upon early recognition, early administration of antibiotics, and early reversal of the shock state.
It's clear that sepsis doesn't occur without an infection in your body, but it is possible that someone develops sepsis without realizing they had an infection in the first place. And sometimes, doctors never discover what the initial infection was.
In a prospective observational analysis, PTX-3, IL-6, procalcitonin (PCT), and lactate combined showed excellent performance in predicting 28-day all-cause mortality among patients diagnosed with sepsis or septic shock and superior to the Sequential Organ Failure Assessment (SOFA) score [24].
What causes sepsis? Most sepsis is caused by bacterial infections, but it can also be caused by viral infections, such as COVID-19 or influenza; fungal infections; or noninfectious insults, such as traumatic injury.
Sepsis is known as the 'silent killer' because its symptoms often mimic that of other illnesses such as the flu or gastro. But, if it is identified and treated early, patients can recover.
Sepsis happens when an infection you already have triggers a chain reaction throughout your body. Infections that lead to sepsis most often start in the lung, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
Most people make a full recovery from sepsis. But it can take time. You might continue to have physical and emotional symptoms. These can last for months, or even years, after you had sepsis.
Many conditions mimic sepsis by meeting criteria for SIRS.
These conditions include: pulmonary embolism (PE), adrenal insufficiency, diabetic ketoacidosis (DKA), pancreatitis, anaphylaxis, bowel obstruction, hypovolemia, colitis, vasculitis, toxin ingestion/overdose/withdrawal, and medication effect.
However, there might be other symptoms related to sepsis based on where the infection is. Abdominal pain is one such symptom.
Sepsis can overwhelm the body. This can cause vital organs to shut down. This usually starts with the kidneys. Blood pressure can drop dangerously low.
If the infection has spread or you have a generalized infection, you may develop other signs and symptoms, such as fever, fatigue, pain, etc. Sometimes however, you may have an infection and not know it, and not have any symptoms.
Observable signs that a provider may notice while assessing a septic patient include poor skin turgor, foul odors, vomiting, inflammation and neurological deficits.
Some of the most frequently isolated bacteria in sepsis are Staphylococcus aureus (S. aureus), Streptococcus pyogenes (S. pyogenes), Klebsiella spp., Escherichia coli (E. coli), and Pseudomonas aeruginosa (P.