Early onset sepsis is usually caused when an infant picks up microorganisms through the placenta or in the birth canal. Late onset infections are acquired from a contaminated environment. Researchers estimate about 2 out of every 1000 infants born in the U.S. develop sepsis. It's the leading cause of death in the NICU in babies who are at least one week old. About 50 percent of those who aren't treated die.
One of the problems with treatment is that infants often don't show any signs of infection until they are quite ill. By that time, sepsis can be very difficult to treat. When a diagnosis is uncertain, some doctors will start treatment before a laboratory confirmation can be made. Other physicians concerned about promoting antibiotic resistance may prefer to wait until they are certain about the diagnosis.
Even when an infant appears to be healthy, there can be some physiologic changes in the body that suggest an infection is starting to take hold. Doctors at the University of Virginia Health System, studied the heart rate characteristics of infants in the NICU and looked for differences between infants who remained healthy and those who developed sepsis. They found infants who developed sepsis had some characteristic changes in the pattern of their heart rate.
The researchers used this information to develop a tool, called the HeRO™ heart rate characteristics monitor. The system continually analyzes signals obtained from the infant's bedside heart rate monitor. A computer uses a formula to calculate the impending risk of sepsis. The information could serve as an early warning signal of a need for intervention, tipping off health care workers 12 or more hours before the baby develops noticeable signs of infection.
HeRO has been approved by the FDA. It is now being evaluated in a clinical trial to see if the device can improve the outcome for NICU infants.