Clinical microbiology of early-onset and late-onset neonatal sepsis, particularly among preterm babies

Abstract

Prematurity has got special challenge for clinicians and also other medical staff, such as microbiologists. Immature host defense mechanisms support early-onset sepsis, which can be very serious with very high mortality. While the past decade has been marked by a significant decline in early-onset group B streptococcal (GBS) sepsis in both term and preterm neonates, the overall incidence of early-onset sepsis has not decreased in many centers, and several studies have found an increase in sepsis due to gram-negative organisms. With increasing survival of these more fastidious preterm infants, late-onset sepsis or specially nosocomial bloodstream infection (BSI) will continue to be a challenging complication that affects other morbidities, length of hospitalization, cost of care, and mortality rates. Especially the very low birthweight (VLBW) infants sensitive to serious systemic infection during their initial hospital stay. Sepsis caused by multiresistant organisms and Candida spp. are also increasing in incidence, has become the most common cause of death among preterm infants. This review focuses on the clinical microbiology of neonatal sepsis, particularly among preterm babies, summarizing the most frequent bacterial and fungal organisms causing perinatally acquired and also nosocomial sepsis.

Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

“…were isolated only in 4 cases (2.86%) causing LOS; two were born preterm, a known risk factor for candidemia [59]. Similar findings were found in other studies in Kenya (2.41%) [40] and India (2.63%) [36].…”

A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

“…was isolated only in four patients who had late onset sepsis. Two of the patients were born preterm, a known risk factor for candidemia [13]. Prevalence of methicillin resistant S. aureus was noted to be low (10.2%) in this neonatal population compared to a similar study looking at bloodstream isolates in all age groups at AKUH-N where it was 21% (76/364) of S. aureus isolates [14].…”

Facultative to strict anaerobes ratio in the preterm infant microbiota

“…intestine, represents a hypothetical, but nevertheless attractive, approach for microbiota modulation in preterm infants. Despite the potential beneficial effects of such interventions on terms of microbiota composition, by reducing the levels of facultative anaerobes which include the most relevant nosocomial infectious agents for this infant population, 6,7 no attention has ever been paid to the effect of such interventions on intestinal microbiota in these infants. However, in addition to the potential benefits of such strategy there are also some potentially deleterious effects that should be carefully evaluated.…”