Topics Discussed: infectious diseases; septicemia; systemic infection.
Excerpt:"Definition. Neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteremia occurring in the first month of life.
Incidence. The incidence of primary sepsis is 1–5 per 1000 live births. The incidence is much higher for very low birthweight (VLBW) infants (BW <1500 g) with early-onset sepsis of 15–19 per 1000 and late-onset nosocomial sepsis at 21% according to data from the National Institute of Child Health and Human Development Neonatal Research Network. The mortality rate is high (13–25%); higher rates are seen in premature infants and in those with early fulminant disease.
Pathophysiology. Neonatal sepsis can be classified into two relatively distinct syndromes based on the age of presentation: early-onset and late-onset sepsis.
- Early-onset sepsis (EOS) presents in the first 5–7 days of life and is usually a multisystem fulminant illness with prominent respiratory symptoms. Typically, the infant has acquired the organism during the intrapartum period from the maternal genital tract. In this situation, the infant is colonized with the pathogen in the perinatal period. Several infectious agents, notably treponemes, viruses, Listeria, and probably Candida, can be acquired transplacentally via hematogenous routes. Acquisition of other organisms is associated with the birth process. With rupture of membranes, vaginal..."
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