What is Early Onset Sepsis (EOS)?
Early Onset Sepsis (EOS) is a critical condition in newborns, typically occurring within the first 72 hours of life. It is caused by a bacterial infection acquired either before or during the delivery process. This condition can lead to severe complications, including systemic inflammation, organ dysfunction, and potentially life-threatening outcomes.
Premature birth
Prolonged rupture of membranes
Maternal fever during labor
Previous infant with GBS disease
Chorioamnionitis
Symptoms and Diagnosis
Symptoms of EOS can be non-specific and may include respiratory distress, temperature instability, lethargy, poor feeding, and irritability. Due to the non-specific nature of these symptoms,
early diagnosis can be challenging.
Diagnosis usually involves a combination of clinical assessment and laboratory tests. A complete blood count (CBC), blood cultures, and sometimes lumbar puncture for cerebrospinal fluid analysis are typically performed. Tests may show elevated white blood cell counts or other markers of infection such as C-reactive protein (CRP) or procalcitonin.
Treatment
The cornerstone of treating EOS is the prompt administration of
antibiotics. Empirical antibiotic therapy is often started immediately after the diagnosis is suspected and before the causative organism is identified. Commonly used antibiotics include ampicillin combined with gentamicin or cefotaxime. Once the specific pathogen is identified, antibiotics may be adjusted based on
culture and sensitivity results.
Prevention
Preventing EOS is a critical component of neonatal care. Pregnant women are usually screened for GBS colonization between 35 and 37 weeks of gestation. If a woman tests positive for GBS, she is typically given intrapartum antibiotic prophylaxis (IAP) during labor to reduce the risk of transmitting the bacteria to the infant. Additionally, maintaining strict hygiene protocols in the delivery room and neonatal intensive care unit (NICU) can help minimize the risk of infection. Prevention strategies also include the timely administration of maternal antibiotics in cases of prolonged rupture of membranes or maternal fever.
Prognosis and Long-term Outcomes
The prognosis for infants with EOS has improved significantly with early recognition and treatment. However, the condition can still lead to serious complications, including
meningitis, pneumonia, and long-term neurodevelopmental issues. Infants who survive EOS may require ongoing medical and developmental follow-up to address any residual effects of the infection.
Conclusion
Early Onset Sepsis is a severe and potentially life-threatening condition in newborns that requires immediate medical attention. Understanding the risk factors, recognizing the symptoms, and initiating prompt treatment are essential to improving outcomes. Preventive measures such as maternal screening and intrapartum antibiotic prophylaxis play a crucial role in reducing the incidence of this serious neonatal disorder.
