Introduction
The majority of medical practitioners and organizations specializing in the delivery of healthcare are concerned about the increased rate of mortality and morbidity among infants and mothers. For this reason, measures have been taken to ensure the reduction of child and maternal mortality rates. For instance, a study carried out by Bishai et al. (2016), showed that such rates have reduced from 43% in 1990 to 40% in 2010, which was attributable to the improvement in education, governance, income, technology, societal changes, and better healthcare. In spite of this, empirical evidence shows that neonatal sepsis adversely affects the efforts taken to ensure reduced cases of child and maternal mortality especially in developing countries. This paper provides an in-depth analysis of the subject of neonatal sepsis.
Background
Neonatal sepsis can be either early-onset or late-onset. In the majority of the cases, early-onset sepsis occurs following the possibility of the baby having acquired various microorganisms from the mother (Shah & Padbury, 2013). Some of the common microorganisms responsible for this category of sepsis include Escherichia coli, coagulase-negative Staphylococcus, Group B Streptococcus (GBS), Listeria monocytogenes, and Haemophilus influenzae. In spite of this, the prevalence of sepsis due to GBS has reduced over time because of the use of prenatal screening as well as other treatment protocol for Group B Streptococcus.
On the other hand, the late-onset sepsis develops later after a child is born, between 4 to 90 days. Often, this category of sepsis results from the caregiving environmental conditions. While a newborn is exposed to numerous microorganisms that can trigger sepsis, the Coagulase-negative Staphylococcus is known to be the major cause of neonatal sepsis.
Literature Review
Neonatal sepsis has been identified as a leading cause of term and preterm infants’ morbidity and mortality (Gebremedhin, Berhe, & Gebrekirstos, 2016; Bishai et al., 2016). In spite of the various measures taken to ensure advanced neonatal care, sepsis still accounts for a significant percentage of morbidity and mortality in infants having very low weight at birth. Neonatal sepsis’s signs and symptoms are not specific (Shah & Padbury, 2013). However, the most common ones experienced in children with sepsis include guaiac-positive stool, hepatomegaly, abdominal distention, bleeding problems, poor perfusion, bulging fontanel, seizures, hypotonia, irritability, feeding difficulties, apnea, and cyanosis among others.
The prevention and treatment of neonatal sepsis is challenging especially in developing countries. A study by Gebremedhin et al. (2016) indicated that the majority of the deaths of newborns in Ethiopia occur due to sepsis. In most of the cases, Gebremedhin et al. (2016) found out that such deaths are associated with factors such as the place of delivery, low birth weight, prematurity, prolonged rupture of membrane (PROM) and intrapartum fever, and the history of UTI/STI during the index pregnancy.
According to PATH (2015), it is recommedable to use either intravenous or intramuscular antibiotics for the treatment of neonatal sepsis. Nevertheless, such guidelines have not been useful since most of the healthcare settings lack hospital-based care. On the other hand, the World Health Organization (WHO) recommends the adoption of an outpatient treatment scheme to reduce child and maternal mortality rate due to neonatal sepsis. According to a study carried out by PATH (2015), it is possible to reduce infant deaths through the use of gentamicin. In spite of this, the only challenge in this case, would be the calculation of dosage.
Recent studies on neonatal sepsis have indicated that the examination of each category of sepsis can be effective in its prevention and treatment (Shah & Padbury, 2013; Schlapbach et al., 2011). As such, following the adoption and implementation of treatment protocol and prenatal screening, the prevalence rate of early-onset sepsis has decreased. The early detection as well as prompt treatment of neonatal sepsis remains to be a challenge due to the fact that the associated symptoms and signs of this illness are nonspecific. Numerous studies have been conducted to identify a number of diagnostic markers such as the cell surface markers, cytokines, procalcitonin, hematological indices, C-reactive protein, and acute phase reactants among others, which can be used in the detection of the signs and symptoms of neonatal sepsis (Shah & Padbury, 2013). In spite of this, there is a need for further researcher to establish a biomarker that is highly accurate.
Conclusion
Based on the analysis above, it is evident that child and maternal mortality is a common problem in healthcare nowadays. While interventions have been adopted to reduce the rate of morbidity and mortality rates of infants, neonatal sepsis has adversely affected such efforts. This is attributable to the fact that sepsis’s symptoms are nonspecific making their early detection and treatment a challenge. The adoption of technology in the healthcare sector has significantly increased the success rate regarding the prevention and treatment of neonatal sepsis. In spite of this, there is still much to be done to efficiently deal with this problem since more accurate and valid markers for the detection of signs and symptoms of neonatal sepsis are yet to be developed.
References
Bishai, D. M., Cohen, R., Alfonso, Y. N., Adam, T., Kuruvilla, S., & Schweitzer, J. (2016). Factors contributing to maternal and child mortality reductions in 146 low- and middle-income countries between 1990 and 2010. PLoS ONE, 11(1), e0144908. Web.
Gebremedhin, D., Berhe, H., & Gebrekirstos, K. (2016). Risk factors for neonatal sepsis in public hospitals of Mekelle City, North Ethiopia, 2015: Unmatched case control study. PLoS ONE, 11(5), e0154798. Web.
PATH. (2015). Gentamicin for treatment of neonatal sepsis — A landscape of formulation, packaging, and delivery alternatives. Seattle: PATH.
Schlapbach, L., Aebischer, M., Adams, M., Natalucci, G., Bonhoeffer, J., Latzin, P., … Latalet., B. (2011). Impact of Sepsis on Neurodevelopmental Outcome in a Swiss National Cohort of Extremely Premature Infants. PEDIATRICS, 128(2), e348-e357.
Shah, B., & Padbury, J. (2013). Neonatal sepsis. Virulence, 5(1), 170-178.