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Neonatal Bacterial and Fungal Infections

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Neonatology

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Abstract

Neonatal infection is the invasion of the tissue by an infectious organism during the neonatal age. This may be considered early-onset when occurring during the first 72 h of life and late-onset when occurring after the first 72 h of life. Reported rates of neonatal infections range from 6% to 33% and up to 40% in neonates born before 28 weeks’ gestational age or with birth weight <1,000 g. Septicemia accounts for 45–55% of all infections, followed by lower respiratory tract infections (16–30%) and urinary tract infections (8–18%). The most frequently isolated microorganisms are coagulase-negative Staphylococci, group B Streptococcus, Escherichia coli, other Enterobacteriaceae and Gram-negative microorganisms, and, among fungi, Candida albicans. Both early-onset and late-onset infections represent a major cause of mortality and morbidity in neonates. Prevention strategies for both early-onset and late-onset infection are available, including prevention of infection associated with premature rupture of membranes and preterm labor, prevention of neonatal group B streptococcal disease, and prevention of neonatal nosocomial infections.

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Abbreviations

AAP:

American Academy of Pediatrics

ACOG:

American College of Obstetricians and Gynecologists

AOM:

Acute otitis media

CDC:

Centers for Disease Control and Prevention

CFU:

Colony-forming unit

CI:

Confidence interval

CONS:

Coagulase-negative Staphylococci

CRP:

C-reactive protein

CT:

Computerized tomography

CVC:

Central venous catheter

DMSA:

Dimercaptosuccinic acid

EOS:

Early-onset neonatal sepsis

GBS:

Group B Streptococcus

G-CSF:

Granulocyte-colony stimulating factor

HICPAC:

Healthcare Infection Control Practices Advisory Committee

IAP:

Intrapartum antibiotic prophylaxis

Ig:

Immune globulins

IL:

Interleukin

IVG:

Intravenous immune globulins

LOS:

Late-onset neonatal sepsis

MIC:

Minimal inhibiting concentration

MRI:

Magnetic resonance imaging

MRSA:

Methicillin-resistant Staphylococcus aureus

NEC:

Necrotizing enterocolitis

NICHD:

National Institute of Child Health and Human Development

NICU:

Neonatal Intensive Care Unit

NTED:

Neonatal toxic shock syndrome-like exanthematous disease

OR:

Odds ratio

PCR:

Polymerase chain reaction

PCT:

Procalcitonin

PROM:

Premature rupture of membranes

RCOG:

Royal College of Obstetricians and Gynaecologists

rRNA:

Ribosomal ribonucleic acid

RR:

Relative risk

SAA:

Serum amyloid A

SSSS:

Staphylococcal scalded skin syndrome

TEN:

Toxic epidermal necrolysis

TSST-1:

Toxic shock syndrome toxin-1

US:

Ultrasound

UTI:

Urinary tract infection

VAP:

Ventilator-associated pneumonia

VLBW:

Very low birth weight

VRE:

Vancomycin-resistant Enterococcus

WHO:

World Health Organization

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico ‘San Matteo’, Pavia, Italy

    Mauro Stronati & Alessandro Borghesi

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  1. Mauro Stronati
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  2. Alessandro Borghesi
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Correspondence to Mauro Stronati .

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  1. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Giuseppe Buonocore

  2. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women’s Hospital Neonatal Unit, Liverpool, UK

    Michael Weindling

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Stronati, M., Borghesi, A. (2018). Neonatal Bacterial and Fungal Infections. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_254

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