title: Late-onset neonatal sepsis: recent developments.
abstract: The incidence of neonatal late-onset sepsis (LOS) is inversely related to the degree of maturity and varies geographically from 0.61% to 14.2% among hospitalised newborns. Epidemiological data on very low birth weight infants shows that the predominant pathogens of neonatal LOS are coagulase-negative staphylococci, followed by Gram-negative bacilli and fungi. Due to the difficulties in a prompt diagnosis of LOS and LOS-associated high risk of mortality and long-term neurodevelopmental sequelae, empirical antibiotic treatment is initiated on suspicion of LOS. However, empirical therapy is often inappropriately used with unnecessary broad-spectrum antibiotics and a prolonged duration of treatment. The increasing number of multidrug-resistant Gram-negative micro-organisms in neonatal intensive care units (NICU) worldwide is a serious concern, which requires thorough and efficient surveillance strategies and appropriate treatment regimens. Immunological strategies for preventing neonatal LOS are not supported by current evidence, and approaches, such as a strict hygiene protocol and the minimisation of invasive procedures in NICUs represent the cornerstone to reduce the burden of neonatal LOS.
authors.affiliation: Department of Paediatrics, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Dong
authors.affiliation: University Children's Hospital, University of Würzburg, Würzburg, Germany.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Speer
mesh_terms: D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infectious Diseases; Microbiology; Neonatology