Infection of the Premature Infant
An infection is due to harmful germs (bacteria, fungi, or viruses) in the baby’s body. Infections can begin before, during, or after birth. All babies have immune systems that are still developing. This system’s job is to fight germs. A newborn’s immune system may not be ready to fight an infection. Premature babies are at an even higher risk of infection than term babies. This is because babies get antibodies (infection-fighting substances) from the mother when they are in the womb. Preemies don’t receive several weeks of antibodies due to being born early.
How are infections diagnosed?
Infection can be detected using tests including:
Cultures of possibly infected areas
Lumbar puncture (spinal tap)
How can infections be prevented?
You will need to follow some rules while your baby is in the NICU (neonatal intensive care unit). These are to protect your baby and the other babies from infection. Common ways to prevent infection include the following:
Wash your hands thoroughly before entering the NICU. Washing your hands well and often is the best way to avoid passing germs to your baby. Be sure you understand and follow any handwashing instructions you are given. You may be told to scrub (wash well with soap and water for several minutes) when you first arrive for a visit. After this first scrub, alcohol-based hand cleansers or a quick wash with soap and water may be needed if you touch anything that could transfer germs to your hands. If you have more than one baby in the NICU, you may be told to wash your hands after touching one and before touching another.
Restrict the number of people who have contact with the baby. Check with NICU staff about rules for visiting siblings or grandparents.
Keep people who are ill out of the NICU. Make sure NICU staff know if you or anybody in your household is sick. If so, you will most likely need to stay out of the NICU until the danger is past.
Keep infants in the NICU from contact with each other. A baby who has an infection or has been exposed to an infection may be kept away from other babies. He or she may be moved to a special part of the NICU.
How are infections treated?
Medicines are used to treat infections. If the germ causing the infection is known, a medicine that targets that germ can be used. If the germ is not known or if targeted medicines aren’t working, medicines that fight many types of germs may be used.
What are the possible complications?
In most cases, babies get over infections with no lasting harm. A severe infection can be life-threatening, even with treatment. Whether your baby has any long-term effects on his or her growth and development depends on the cause of your baby's infection and how your baby responds to treatment.
Wash your hands to prevent infection
People who have contact with the baby should follow the steps below to wash their hands. Also follow any other instructions from NICU staff. If there are other children in the family, you may need to help them wash their hands.
Use warm water and plenty of soap to work up a good lather.
Clean your whole hand, under your nails, between your fingers, and up your wrists. Don’t just wipe—rub well.
Keep washing for at least 10 to 15 seconds. You may be surprised by how long this takes, so be sure to count.
Rinse. Let the water run down your fingertips, not up your wrists.
September 30, 2017
Bacterial meningitis in the neonate: clinical features and diagnosis. UpToDate., Clinical features and diagnosis of bacterial sepsis in the preterm neonate. UpToDate., Clnical manifestations and diagnosis of Candida infections in neonates. UpToDate., Healthcare-associated infections in the hospitalized neonate: a review. T.A. Hooven. Early Human Development. 2014;90(Suppl 1):S4-6., Nosocomial viral infections in the neonatal intensive care unit. UpToDate., Polin, RA. Strategies for Prevention of Health Care Associated Infections in the NICU. Pediatrics 92012); 129(4); pp. s1085-s1093, Treatment and prevention of bacterial sepsis in the preterm neonate. UpToDate.
Freeborn, Donna, PhD, CNM, FNP,Image reviewed by StayWell art team.,Lee, Kimberly G., MD, MSc, IBCLC