title: Neonatal sepsis: an old problem with new insights.
abstract: Neonatal sepsis continues to be a common and significant health care burden, especially in very-low-birth-weight infants (VLBW<1500 g). Though intrapartum antibiotic prophylaxis has decreased the incidence of early-onset group B streptococcal infection dramatically, it still remains a major cause of neonatal sepsis. Moreover, some studies among VLBW preterm infants have shown an increase in early-onset sepsis caused by Escherichia coli. As the signs and symptoms of neonatal sepsis are nonspecific, early diagnosis and prompt treatment remains a challenge. There have been a myriad of studies on various diagnostic markers like hematological indices, acute phase reactants, C-reactive protein, procalcitonin, cytokines, and cell surface markers among others. Nonetheless, further research is needed to identify a biomarker with high diagnostic accuracy and validity. Some of the newer markers like inter α inhibitor proteins have shown promising results thereby potentially aiding in early detection of neonates with sepsis. In order to decrease the widespread, prolonged use of unnecessary antibiotics and improve the outcome of the infants with sepsis, reliable identification of sepsis at an earlier stage is paramount.
authors.affiliation: Instructor of Pediatrics; Neonatal-Perinatal Medicine; Warren Alpert Medical School of Brown University; Women & Infants Hospital of Rhode Island; Providence, RI USA.
authors.forename: Birju A
authors.initials: BA
authors.lastname: Shah
authors.affiliation: Pediatrician-in-Chief, Professor of Pediatrics; Warren Alpert Medical School of Brown University; Women & Infants Hospital of Rhode Island; Providence, RI USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Padbury
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D004926:Escherichia coli; D004927:Escherichia coli Infections / Q000175:diagnosis; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013292:Streptococcus agalactiae
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: algorithms; antibiotic prophylaxis; biomarkers; epidemiology; group B streptococcus; microbiology; neonatal sepsis; newer tests; screening