Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Hospital-Acquired 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
Click here for the Professional Version
Topic Resources

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 and do not occur at delivery.

  • 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.

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 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 and full-term newborns who have serious medical disorders.

In full-term newborns, the most frequent hospital-acquired infection is a skin infection resulting from the bacteria Staphylococcus aureus Staphylococcus aureus Infections Staphylococcus aureus is the most dangerous of all of the many common staphylococcal bacteria. These gram-positive, sphere-shaped (coccal) bacteria (see figure How Bacteria Shape Up) often cause... read more Staphylococcus aureus Infections . 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 Neonatal intensive care unit (NICU) Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 10% of newborns need special care after birth due to prematurity, problems... read more (NICUs) and the more procedures they have done, the higher is their likelihood of infection.

Symptoms

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.

Diagnosis

  • Various other tests

Hospital-acquired infection is suspected based on a doctor's examination.

Doctors may then test blood, urine, and spinal fluid samples to determine where the infection is and which organism is causing it.

Prevention

General measures that hospital staff members use to help prevent hospital-acquired infections include the following:

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.

Treatment

  • Depends on the organism

Treatment of hospital-acquired infections depends on the specific organism causing the infection.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read
Test your knowledge
Colic
Colic is the term used for a pattern of intense, excessive crying and fussing that occurs for no apparent reason in some infants. It typically begins within the first month of life. At what age does colic typically end?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
TOP