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Hospital-Acquired Infections in Newborns

ByAnnabelle de St. Maurice, MD, MPH, UCLA, David Geffen School of Medicine
Reviewed/Revised Apr 2025
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Hospital-acquired infections in newborns are infections that develop after newborns have been admitted to the hospital nursery. These infections are not transmitted from the mother when the baby is in the womb and do not occur at delivery.

Topic Resources

  • 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.

  • Infections are treated based on the cause.

  • Various measures, such as handwashing, can help prevent spreading infections.

(See also Overview of Infections in Newborns.)

Some newborns acquire an infection after they are admitted to the hospital nursery rather than from their 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, preterm 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 medications.

In full-term newborns, the most frequent hospital-acquired infection is a skin infection resulting from the bacteria Staphylococcus aureus. Often, these 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 an IV 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 Hospital-Acquired Infections in Newborns

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.

Diagnosis of Hospital-Acquired Infections in Newborns

  • Various tests

Hospital-acquired infection is suspected based on the newborn's condition and a doctor's examination.

Lab Test

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

Treatment of Hospital-Acquired Infections in Newborns

  • Depends on the organism

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

Prevention of Hospital-Acquired Infections in Newborns

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

  • Careful handwashing

  • Monitoring for infection in the hospital

  • Sometimes antibiotics

  • Vaccination

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 hospital 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.

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