Neonatal sepsis: A review of the literature

Abstract

Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is a major public health challenge around the world. Depending on the mode of occurrence, a distinction is made between maternal-transmitted infection and that acquired in the postnatal period. Although the etiologies maternally transmitted diseases are well understood, those of postnatal acquired infections are variable depending on the epidemiology of each hospital environment. On the one hand, risk factors for maternal-transmitted infections are maternal sepsis, prolonged premature rupture of membranes, chorioamnionitis, and bacteriuria in the mother during pregnancy. On the other hand, risk factors for postnatal acquired infections are prematurity, low birth weight, lack of hygiene, and invasive therapeutic interventions. The diagnosis is based on a series of anamnestic, clinical and biological features. Although the positive diagnosis is based on the isolation of the germ by culture on a body sample (blood, cerebrospinal fluid, urine, etc.); its low sensitivity leads to the use of markers of the acute phase of inflammation such as C-reactive protein, procalcitonin and interleukins. New molecular biology techniques are promising and offer precise diagnosis with rapid results. Empirical management is a function of microbial ecology while definitive treatment is guided by the results of microbial culture. This article presents the essential elements for understanding neonatal sepsis and discusses new diagnosis and therapeutic management. It offers a thorough reading based on the issue of infections in newborns.

Clinico-etiological profile of neonatal sepsis at a tertiary care hospital in South India

“…We reported nonspecific findings in most of the cases followed by gastrointestinal symptoms in 18 cases, meningitis in 16 cases and pneumonia in 12 cases. These presentations are similar to previously published clinical presentations [3][4][5][6].…”

“…The microorganisms implicated in neonatal sepsis in developing countries differ from those seen in developed countries [3]. In our study, out of 88 positive cultures, the majority of causative microorganisms were Gram-negative (85.22%), specifically Klebsiella (45%) and E. coli (31%).…”

“…On the other hand, late-onset sepsis occurs when features of sepsis develop in a neonate older than 72 hours and is predominantly community or hospital-acquired. The pattern of microorganisms causing it are those present in the environment where the neonate is cared for and nursed [2,3]. Recent data published by the World Health Organization (WHO) estimates that 5 million neonates die each year and around a quarter of those deaths are sepsis-related [3].…”

“…The pattern of microorganisms causing it are those present in the environment where the neonate is cared for and nursed [2,3]. Recent data published by the World Health Organization (WHO) estimates that 5 million neonates die each year and around a quarter of those deaths are sepsis-related [3]. Data from the National Neonatal Perinatal Database (NNPD, 2002-03) attributes 19% of all neonatal deaths to sepsis [4].…”

Adverse birth outcomes and associated factors among newborns delivered in a western African country: a case‒control study

“…In developing countries, the incidence of neonatal septicemia ranges from 1.6% to 3.8% of all live births, considering that the neonatal sepsis definition varies, and most countries are not able to have a microbiological confirmation, such as STP [46,47]. Moreover, the rates of neonatal sepsis in STP are probably much higher since we only included babies diagnosed while admitted to the maternity unit.…”