Neonatal Urosepsis

Sepsis is a serious blood infection. It means that lots of germs have gotten into the blood. When the infection starts in the urinary tract and spreads to the blood, it is called urosepsis. If this develops in an infant younger than 90 days, it is called neonatal urosepsis.

Newborns cannot fight off infection as well as older children. It is easier for a urinary tract infection to spread to the newborn's blood. From the blood, it can spread to other parts of the body. It is very important to treat the newborn as soon as the infection is found.

CAUSES

Neonatal urosepsis is caused 2 ways:

  • Usually, bacteria get into a newborn's blood from somewhere in the body. The blood then carries the bacteria into the urinary tract. The bacteria grow and multiply in the kidneys or bladder, and go back into the bloodstream.

  • Sometimes, bacteria get into the urinary tract from outside the body. Bacteria come in through the urethra. When this happens, an infection usually starts in the bladder. It spreads to the kidneys and then into the bloodstream.

Certain conditions make it more likely that a newborn will develop urosepsis. They include:

  • Being born before 37 weeks of pregnancy (prematurely). Premature newborns have aharder time fighting infection than newborns not born prematurely. There is a greater chance that the infection will spread to their blood.

  • Being male. More newborn males than femalesget urinary tract infections.

  • Having an abnormal urinary tract. If the urine cannot flow the normal way, infection is more likely.

SYMPTOMS

Symptoms of a urinary tract infection in newborns may include:

  • Fever.

  • Yellowing of the skin or eyes (jaundice).

  • No interest in eating.

  • No weight gain.

  • Being inactive.

  • Throwing up (vomiting).

  • Being very fussy.

  • Urine that is cloudy or bloody. It also may have an odd smell.

Signs that a urinary tract infection may have spread into the blood include:

  • Pale or blue skin.

  • High fever.

  • Being very sleepy.

  • Little movement. The newborn may seem floppy.

  • Skin rash.

  • Small amounts of urine.

  • Trouble breathing.

DIAGNOSIS

To find out if a newborn has urosepsis, the newborn's caregiver may perform a physical exam, urine and blood tests, a spinal tap, or other imaging tests (ultrasound or void cystourethrography).

TREATMENT

Newborns with urosepsis almost always need to stay in a hospital while they are being treated. This may take a few weeks. Treatment usually includes:

  • Medicines to treat infections (antibiotics). The medicine will be given through an intravenous (IV) access tube.

  • One or more antibiotics may be given at first. Sometimes these are changed if the urine or blood tests show a different antibiotic would work better.

Steps are taken to help the newborn's body (supportive care). These may include:

  • Fluids given through the IV. Without fluids, the newborn can lose body fluid(dehydrated). Fluids also can help keep the newborn's blood pressure steady.

  • Blood pressure medicine. This may be needed if the newborn's blood pressure gets too low.

  • A machine that helps the newborn breathe (respirator). A small tube is put in the newborn's throat. Then, the respirator controls the newborn's breaths.

  • Feedings through an IV. This is needed if the newborn is using a respirator.