Hospital-Acquired Infections in Newborns
These infections can be caused by bacteria, viruses, or fungi.
Symptoms vary but may include vomiting, fever, and a rash.
The diagnosis is typically based on a physical examination.
Various measures, such as handwashing, can help prevent spreading infections.
Infections are treated based on the cause.
(See also Overview of Infections in Newborns.)
Some infections are acquired after admission to the newborn nursery rather than from the mother in utero (in the womb) or during delivery. Sometimes it is not clear whether the source is the mother or the hospital environment. Infections acquired in the hospital are mainly problems for newborns who have to stay in the hospital for a long time, for example, premature newborns and full-term newborns who have serious medical disorders.
The most common hospital-acquired infections are pneumonia (lung infection) and blood infections (bacteremia) resulting from a catheter that has been inserted into a vein (also called an IV) to give the newborn fluids or drugs.
In full-term newborns, the most frequent hospital-acquired infection is a skin infection resulting from the bacteria Staphylococcus aureus. Often, infections are not noticed until newborns are at home.
In very-low-birth-weight infants, the majority of hospital-acquired infections also are caused by staphylococci. But certain other bacteria and fungi also are causes. The lower the birth weight, the higher the risk of infection, particularly in newborns who need to be on a ventilator or need IVs for a long time. The longer newborns stay in special care nurseries or neonatal intensive care units (NICUs) and the more procedures they have done, the higher is their likelihood of infection.
Symptoms of infection in newborns tend to be nonspecific. For example, newborns may have vomiting or poor feeding, increased sleepiness or lethargy, fever or low temperature, fast breathing, rashes, diarrhea, or a swollen abdomen. Many infections acquired before birth can cause or be accompanied by various symptoms or abnormalities.
General measures that hospital staff members use to help prevent hospital-acquired infections include the following:
Measures to reduce the spread of Staphylococcus aureus
Prevention of spread and infection in special care nurseries such as NICUs
Monitoring for infection in the hospital
To reduce the spread of infection during a disease outbreak in the hospital, doctors may apply antibiotic ointments to the newborn's umbilical cord, nostrils, and circumcision site.
To reduce the spread of infection in special care nurseries such as NICUs, hospital staff members ensure there is sufficient space between newborns who are in incubators or warmers. They also are careful to meticulously clean and disinfect or sterilize equipment and use IVs and ventilators for as short a time as possible.
Hospital staff members, parents, and caregivers can help prevent the spread of hospital-acquired infections by always thoroughly washing their hands with soap and water or with antibacterial hand sanitizer.
While in the hospital, newborns are carefully monitored for any signs of infection.
If doctors determine an infection is spreading through the nursery, they may give certain antibiotics to newborns who are not yet infected. This preventive measure is called prophylaxis.
Hospital staff members give vaccines according to the routine schedule to any infant who is in the hospital at that time. Some vaccines are not given until the time of discharge.