Abstract

Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.

Original languageEnglish (US)
Pages (from-to)21-47
Number of pages27
JournalClinical Microbiology Reviews
Volume27
Issue number1
DOIs
StatePublished - Jan 10 2014

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Streptococcus agalactiae
Ampicillin
Parechovirus
Very Low Birth Weight Infant
Cefotaxime
Enterovirus
Calcitonin
Cell Adhesion Molecules
Simplexvirus
Surface Antigens
Gentamicins
Interleukin-8
Meningitis
Premature Infants
C-Reactive Protein
Interferon-gamma
Interleukin-6
Sepsis
Differential Diagnosis
Vaccines

ASJC Scopus subject areas

  • Epidemiology
  • Immunology and Microbiology(all)
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Early-onset neonatal sepsis. / Simonsen, Kari A; Anderson Berry, Ann L; Delair, Shirley F.; Davies, Herbert Dele.

In: Clinical Microbiology Reviews, Vol. 27, No. 1, 10.01.2014, p. 21-47.

Research output: Contribution to journalArticle

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