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Overview of Infections in Newborns

By

Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Last full review/revision Jul 2020| Content last modified Jul 2020
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Infections occur at all ages but are a great cause for concern in newborns because newborns, especially premature ones Premature Newborn A premature newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, premature newborns have underdeveloped organs, which may not be ready to function outside... read more , have an underdeveloped immune system and are more susceptible to infection. Although certain protective antibodies Antibodies One of the body's lines of defense (immune system) involves white blood cells (leukocytes) that travel through the bloodstream and into tissues, searching for and attacking microorganisms and... read more Antibodies pass from the mother to the fetus through the placenta (the organ that provides nourishment to the fetus), the levels of antibodies in the fetus's blood may not be high enough to fight an infection.

Fetuses and newborns can acquire an infection in the following ways:

  • In the womb

  • During birth

  • After birth

Infection acquired in the womb (in utero infection)

An infection in the fetus, which can occur any time before birth, results from an infection in the mother. Sometimes doctors and the mother know she has an infection, but sometimes they do not. The mother's infection is passed to the fetus through the placenta.

Common infections that are passed on via the placenta include rubella Rubella in Newborns Rubella is a typically mild childhood viral infection that may, however, have devastating consequences for infants infected before birth. Rubella is caused by a virus. The fetus or newborn may... read more , toxoplasmosis Toxoplasmosis in Newborns Toxoplasmosis is infection with the parasite Toxoplasma gondii. It usually does not cause problems in healthy adults, but it can cause serious illness in newborns and in people with a weakened... read more , cytomegalovirus Cytomegalovirus (CMV) Infection in Newborns Cytomegalovirus is a common virus that usually causes few or no problems but can cause serious illness in infants who are infected before birth or around the time of birth. Cytomegalovirus infection... read more , Zika virus infection Zika Virus Infection Zika virus infection is a mosquito-borne viral infection that typically causes no symptoms but can cause fever, rash, joint pain, or infection of the membrane that covers the white of the eye... read more Zika Virus Infection , and syphilis Syphilis in Newborns Syphilis is an infection caused by the bacteria Treponema pallidum. It causes serious problems in infants infected before birth. Syphilis is caused by bacteria. Serious complications may develop... read more Syphilis in Newborns . Human immunodeficiency virus (HIV) infection Human Immunodeficiency Virus (HIV) Infection in Children Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and causes acquired immunodeficiency syndrome (AIDS). Human immunodeficiency... read more and hepatitis B virus infection Hepatitis B Virus (HBV) Infection in Newborns Hepatitis B virus infection causes inflammation of the liver. Newborns may become infected at birth or rarely after birth. Newborns who develop symptoms have jaundice, lethargy, and failure... read more may also sometimes be passed on via the placenta. There are also many rarer infections that can infect the fetus before birth.

Infection acquired during birth (intrapartum infection)

An infection can be acquired during birth if the baby passes through an infected birth canal or if an infection moves up from the vagina if delivery is delayed after the membranes have ruptured.

Infections that can occur during birth include HIV infection Human Immunodeficiency Virus (HIV) Infection in Children Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and causes acquired immunodeficiency syndrome (AIDS). Human immunodeficiency... read more , herpes simplex virus infections Herpes Simplex Virus (HSV) Infections Herpes simplex virus infection causes recurring episodes of small, painful, fluid-filled blisters on the skin, mouth, lips (cold sores), eyes, or genitals. This very contagious viral infection... read more Herpes Simplex Virus (HSV) Infections , hepatitis B virus infection Overview of Hepatitis Hepatitis is inflammation of the liver. (See also Overview of Acute Viral Hepatitis and Overview of Chronic Hepatitis.) Hepatitis is common throughout the world. Hepatitis can be Acute (short-lived) read more , streptococcal infections Streptococcal Infections Streptococcal infections are caused by any one of several species of Streptococcus. These gram-positive, sphere-shaped (coccal) bacteria (see figure How Bacteria Shape Up) cause many disorders... read more , E. coli infections Escherichia coli Infections Escherichia coli (E. coli) are a group of gram-negative bacteria that normally reside in the intestine of healthy people, but some strains can cause infection in the digestive tract, urinary... read more , listeriosis Listeriosis Listeriosis is infection caused by the gram-positive bacteria Listeria monocytogenes, usually when contaminated food is eaten. People may consume the bacteria in contaminated dairy products... read more , gonococcal infections Gonorrhea Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover the front... read more Gonorrhea , and chlamydia Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted diseases of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect the membranes... read more Chlamydial and Other Nongonococcal Infections . Sometimes these infections can also be passed on through the placenta.

Infection acquired after birth (postpartum infection)

An infection acquired after birth occurs when a newborn has close contact with an infected mother directly or through breastfeeding. An infection acquired after birth can also occur if newborns have contact with infected health care practitioners, family, or visitors in the hospital (see Hospital-Acquired Infections in Newborns) Hospital-Acquired Infections in Newborns Hospital-acquired infections in newborns are infections that develop after newborns have been admitted to the nursery. These infections do not come from the mother when the baby is in the womb... read more or at home.

Types of infections in newborns

Infections in newborns are usually caused by bacteria or viruses and less commonly by fungi or parasites. Bacteria include group B streptococci Types of streptococci Streptococcal infections are caused by any one of several species of Streptococcus. These gram-positive, sphere-shaped (coccal) bacteria (see figure How Bacteria Shape Up) cause many disorders... read more , Escherichia coli Escherichia coli Infections Escherichia coli (E. coli) are a group of gram-negative bacteria that normally reside in the intestine of healthy people, but some strains can cause infection in the digestive tract, urinary... read more (E. coli), Listeria monocytogenes Listeriosis Listeriosis is infection caused by the gram-positive bacteria Listeria monocytogenes, usually when contaminated food is eaten. People may consume the bacteria in contaminated dairy products... read more , gonococci Gonorrhea Gonorrhea is a sexually transmitted disease caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, and throat or the membranes that cover the front... read more Gonorrhea , and chlamydiae Chlamydial and Other Nongonococcal Infections Chlamydial infections include sexually transmitted diseases of the urethra, cervix, and rectum that are caused by the bacteria Chlamydia trachomatis. These bacteria can also infect the membranes... read more Chlamydial and Other Nongonococcal Infections . Viruses include herpes simplex viruses Herpes Simplex Virus (HSV) Infections Herpes simplex virus infection causes recurring episodes of small, painful, fluid-filled blisters on the skin, mouth, lips (cold sores), eyes, or genitals. This very contagious viral infection... read more Herpes Simplex Virus (HSV) Infections (HSV), human immunodeficiency virus Human Immunodeficiency Virus (HIV) Infection in Children Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and causes acquired immunodeficiency syndrome (AIDS). Human immunodeficiency... read more (HIV), cytomegalovirus Cytomegalovirus (CMV) Infection Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms: from no symptoms to fever and fatigue (resembling infectious mononucleosis) to severe symptoms involving... read more (CMV), and hepatitis B virus Hepatitis B, Acute Acute hepatitis B is inflammation of the liver that is caused by the hepatitis B virus and that lasts from a few weeks up to 6 months. Hepatitis B is spread through contact with blood or other... read more (HBV).

Some infections that can affect people of all ages cause particular problems when they occur in a fetus or newborn. Some of the more serious infections in newborns include the following:

Diagnosis of Infections in Newborns

  • A doctor's examination

  • Various tests

Doctors suspect an infection based on the newborn's symptoms or abnormalities (such as birth defects) and on the results of a physical examination.

Doctors also do blood tests and test samples of the newborn's blood, spinal fluid, urine, saliva, or tissues to determine which organism is causing the infection. The mother may also be tested.

Treatment of Infections in Newborns

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Preventive Health Care Visits in Infants
Frequent doctor visits are recommended for all infants younger than 1 year of age. These visits, also called well-child visits, make it possible to check development, look for health problems, provide age-appropriate vaccinations, and educate parents. Which of the following is a condition that might affect some infants born very prematurely, with less than 32 weeks of development in the uterus?
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