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Neonatal Bacterial Infections

  • Thomas A. Hooven
  • Richard A. Polin
Chapter

Abstract

The neonate is uniquely susceptible to bacterial infections, which can range from a subtle to a flagrant presentation. Early identification and treatment of bacterial infection in the newborn can prevent major complications and often depend on consideration of risk factors—such as chorioamnionitis and prolonged rupture of the membranes—in combination with careful, repeated physical examinations.

This chapter presents cases that illustrate key principles of diagnosing and treating neonatal sepsis and meningitis. It reviews appropriate steps in evaluating a newborn with a history and clinical presentation suggestive of sepsis, including the value of screening laboratory tests, such as C-reactive protein and procalcitonin. The chapter also reviews a significant recent development in the field of neonatal sepsis: introduction of a publicly accessible calculator to quantify a newborn’s risk, based on maternal history and clinical presentation. This sepsis calculator is powered by large clinical datasets and represents an important step forward in the effort to rationally assess the risk of sepsis.

While bacterial infection should be considered early in the evaluation of any baby with an unstable presentation, not all symptomatic newborns require antibiotics. This chapter also aims to discuss the familiar dilemma of when and how to evaluate and empirically treat symptomatic newborns, emphasizing that in some cases—particularly during the first 6 h of life when the physiologic transition may still be occurring—watchful waiting is an appropriate course of action.

Keywords

Sepsis Meningitis Sepsis calculator Chorioamnionitis C-reactive protein Procalcitonin Group B Streptococcus 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PediatricsVagelos College of Physicians and Surgeons, Columbia UniversityNew YorkUSA

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