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VOLUME 1 , ISSUE 3 ( July-September, 2019 ) > List of Articles

REVIEW ARTICLE

Recent Advances in Diagnosis, Prevention and Treatment of Neonatal Sepsis

Tanushri Mukherjee, Sanjay Wazir

Keywords : Adjuvant treatment, Antibiotics, Developing countries, Early onset sepsis, Empiric treatment, Late-onset sepsis, Neonate

Citation Information : Mukherjee T, Wazir S. Recent Advances in Diagnosis, Prevention and Treatment of Neonatal Sepsis. Pediatr Inf Dis 2019; 1 (3):108-113.

DOI: 10.5005/jp-journals-10081-1213

License: CC BY-NC 4.0

Published Online: 16-07-2020

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Sepsis is one of the most common causes of morbidity and mortality in the neonatal period. Although this is a global problem, the magnitude of the problem is huge in developing countries because of a lack of clear guidelines for the management of the condition, lack of standard laboratory services and impulsivity of the clinician in changing the antibiotics for any slight deterioration which can be explained by other noninfectious conditions. The source of infection in the baby can be from the mother called the early onset sepsis or from the community or hospital called the late-onset sepsis. Proper identification and knowledge of the causative microorganism can help decide the right antibiotic and causative microorganisms in one area or hospital would be different from the other area and hence it is prudent to make efforts for the identification of the organism causing the disease. Treatment requires the judicious use of antibiotics with the proper choice of antibiotics as well as proper dose and duration. Overuse of antibiotics should be discouraged because of risk of complications and resistance development.


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  1. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med 2018;6(3):223–230. DOI: 10.1016/S2213-2600(18)30063-8.
  2. Oza S, Lawn JE, Hogan DR, et al. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000-2013. Bull World Health Organ 2015;93(1):19–28. DOI: 10.2471/BLT.14.139790.
  3. Report of the National Neonatal Perinatal Database. Report 2002–2003. NNPD Network. 2005 Jan; http://www.newbornwhocc.org/pdf/nnpd_repo rt_2002-03.pdf.
  4. Jajoo M, Manchanda V, Chaurasia S, et al. Alarming rates of antimicrobial resistance and fungal sepsis in outborn neonates in North India. PLoS One 2018;13(6):e0180705. DOI: 10.1371/journal.pone.0180705.
  5. Saha SK, Schrag SJ, El Arifeen S, et al. Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study. Lancet 2018;392(10142):145–159. DOI: 10.1016/S0140-6736(18)31127-9.
  6. Dutta S, Reddy R, Sheikh S, et al. Intrapartum antibiotics and risk factors for early onset sepsis. Arch Dis Child Fetal Neonatal Ed 2010;95(2):F99–F103. DOI: 10.1136/adc.2009.163220.
  7. Newman TB, Puopolo KM, Wi S, et al. Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics 2010;126(5):903–909. DOI: 10.1542/peds.2010-0935.
  8. Hornik CP, Benjamin DK, Becker KC, et al. Use of the complete blood cell count in early-onset neonatal sepsis. Pediatr Infect Dis J 2012;31(8):799–802. DOI: 10.1097/INF.0b013e318256905c.
  9. Schmutz N, Henry E, Jopling J, et al. Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited. J Perinatol 2008;28(4):275–281. DOI: 10.1038/sj.jp.7211916.
  10. Pourcyrous M, Bada HS, Korones SB, et al. Significance of serial C-reactive protein responses in neonatal infection and other disorders. Pediatrics 1993;92(3):431–435.
  11. Puopolo KM, Benitz WE, Zaoutis TE, et al. Management of neonates born at ≥35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018;142(6):e20182894. DOI: 10.1542/peds.2018-2894.
  12. Benitz WE, Wynn JL, Polin RA. Reappraisal of guidelines for management of neonates with suspected early-onset sepsis. J Pediatr 2015;166((4):1070–1074. DOI: 10.1016/j.jpeds.2014.12.023.
  13. Stocker M, van Herk W, El Helou S, et al. Procalcitonin-guided decision making for duration of antibiotic therapy in neonates with suspected early-onset sepsis: a multicentre, randomised controlled trial (NeoPIns). Lancet 2017;390(10097):871–881. DOI: 10.1016/S0140-6736(17)31444-7.
  14. Zhou M, Cheng S, Yu J, et al. Interleukin-8 for diagnosis of neonatal sepsis: a metaanalysis. PLoS One 2015;10(5):e0127170. DOI: 10.1371/journal.pone.0127170.
  15. Hedegaard SS, Wisborg K, Hvas AM. Diagnostic utility of biomarkers for neonatal sepsis--a systematic review. Infect Dis (Lond) 2015;47(3):117–124. DOI: 10.3109/00365548.2014.971053.
  16. Jardine LA, Sturgess BR, Inglis GD, et al. Neonatal blood cultures: effect of delayed entry into the blood culture machine and bacterial concentration on the time to positive growth in a simulated model. J Paediatr Child Health 2009;45(4):210–214. DOI: 10.1111/j.1440-1754.2008.01455.x.
  17. Kennaugh JK, Gregory WW, Powell KR, et al. The effect of dilution during culture on detection of low concentrations of bacteria in blood. Pediatr Infect Dis 1984;3(4):317–318. DOI: 10.1097/00006454-198407000-00008.
  18. Schelonka RL, Chai MK, Yoder BA, et al. Volume of blood required to detect common neonatal pathogens. J Pediatr 1996;129(2):275–278. DOI: 10.1016/S0022-3476(96)70254-8.
  19. Struthers S, Underhill H, Albersheim S, et al. A comparison of two versus one blood culture in the diagnosis and treatment of coagulase-negative staphylococcus in the neonatal intensive care unit. J Perinatol 2002;22(7):547–549. DOI: 10.1038/sj.jp.7210792.
  20. Garges HP, Moody MA, Cotten CM, et al. Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics 2006;117(4):1094–1100. DOI: 10.1542/peds.2005-1132.
  21. Johnson CE, Whitwell JK, Pethe K, et al. Term newborns who are at risk for sepsis: are lumbar punctures necessary? Pediatrics 1997;99(4):E10. DOI: 10.1542/peds.99.4.e10.
  22. Committee on Infectious Diseases, Committee on Fetus and Newborn, Baker CJ, et al. Policy statement—recommendations for the prevention of perinatal group B streptococcal (GBS) disease. Pediatrics 2011;128(3):611–616. DOI: 10.1542/peds.2011-1466.
  23. Greenwood C, Morrow AL, Lagomarcino AJ, et al. Early empiric antibiotic use in preterm infants is associated with lower bacterial diversity and higher relative abundance of Enterobacter. J Pediatr 2014;165(1):23–29. DOI: 10.1016/j.jpeds.2014.01.010.
  24. Alexander VN, Northrup V, Bizzarro MJ. Antibiotic exposure in the newborn intensive care unit and the risk of necrotizing enterocolitis. J Pediatr 2011;159(3):392–397. DOI: 10.1016/j.jpeds.2011.02.035.
  25. Ohlsson A, Lacy JB. Intravenous immunoglobulin for preventing infection in preterm and/or low birth weight infants. Cochrane Database Syst Rev 2013;7:CD000361. DOI: 10.1002/14651858.CD000361.pub3.
  26. Ohlsson A, Lacy JB. Intravenous immunoglobulin for suspected or proven infection in neonates. Cochrane Database Syst Rev 2015;3:CD001239. DOI: 10.1002/14651858.CD001239.pub5.
  27. Carr R, Modi N, Doré C. G-CSF and GM-CSF for treating or preventing neonatal infections. Cochrane Database Syst Rev 2003;3:CD003066. DOI: 10.1002/14651858.CD003066.
  28. Pammi M, Haque KN. Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates. Cochrane Database Syst Rev 2015;3:CD004205. DOI: 10.1002/14651858.CD004205.pub3.
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