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Review
. 2015 May;100(3):F257-63.
doi: 10.1136/archdischild-2014-306213. Epub 2014 Nov 25.

Late-onset neonatal sepsis: recent developments

Ying Dong  1 , Christian P Speer  2
Affiliations
Review

Late-onset neonatal sepsis: recent developments

Ying Dong et al. Arch Dis Child Fetal Neonatal Ed. 2015 May.

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.

Keywords: Infectious Diseases; Microbiology; Neonatology.

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Figures

Figure 1
Figure 1
Major causative pathogens of neonatal late-onset sepsis and their incidence by geographical areas.
See this image and copyright information in PMC

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