Summary
Neonates are predisposed to infections during the perinatal period due to multiple
exposures and a relatively compromised immune system. The burden of disease attributed
to neonatal infections varies by geographic region and maternal and neonatal risk
factors. Worldwide, it is estimated that more than 1.4 million neonatal deaths annually
are the consequence of invasive infections. Risk factors for early-onset neonatal
sepsis (EOS) include prematurity, immunologic immaturity, maternal Group B streptococcal
colonization, prolonged rupture of membranes, and maternal intra-amniotic infection.
Intrapartum antimicrobial prophylaxis administered to GBS-colonized women has reduced
the burden of disease associated with early onset GBS invasive infections. Active
surveillance has identified Gram-negative pathogens as an emerging etiology of early-onset
invasive infections. Late-onset neonatal sepsis (LOS) attributable to Gram-positive
organisms, including coagulase negative Staphylococci and Staphylococcus aureus, is associated with increased morbidity and mortality among premature infants. Invasive
candidiasis is an emerging cause of late-onset sepsis, especially among infants who
receive broad spectrum antimicrobial agents. Prophylactic fluconazole administration
to very low birthweight (VLBW) neonates during the first 6 weeks of life reduces invasive
candidiasis in neonatal intensive care units with high rates of fungal infection.
Prevention of healthcare associated infections through antimicrobial stewardship,
limited steroid use, early enteral feeding, limited use of invasive devices and standardization
of catheter care practices, and meticulous hand hygiene are important and cost-effective
strategies for reducing the burden of late-onset neonatal sepsis.
Keywords
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Article info
Publication history
Published online: October 21, 2013
Accepted:
September 20,
2013
Identification
Copyright
© 2013 The British Infection Association. Published by Elsevier Inc. All rights reserved.
