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The mystery of neonatal sepsis: What exactly triggers this deadly infection?
Neonatal sepsis is a newborn infection, specifically a bacterial bloodstream infection (BSI) in the blood of a newborn baby. Based on historical literature, neonatal sepsis may be referred to as "septic neonatorum." Criteria related to circulatory or respiratory failure are not clinically useful because these symptoms usually develop only when death is imminent. Neonatal sepsis is divided into two categories: early-onset sepsis (EOS) and late-onset sepsis (LOS). EOS refers to sepsis occurring within the first seven days of life, whereas LOS refers to sepsis occurring after seven days. This condition is the most common cause of neonatal death in developing countries.
Symptoms of neonatal sepsis are nonspecific and include temperature changes, breathing problems, diarrhea, low blood sugar, and decreased activity.
Risk factors for neonatal sepsis include the mother's health, particularly the presence of group B streptococcal (GBS) infection. Screening of mothers and providing prophylactic antibiotic therapy during pregnancy for those infected will reduce the risk of neonatal sepsis. Additionally, abnormal heart rate characteristics may also be a risk indicator for impending sepsis.
Diagnostic Methods
In diagnosing neonatal sepsis, blood culture, autologous fluid cell count and other related tests are usually required. These tests can identify the source of infection, however blood cultures have a low sensitivity and can sometimes result in false-negative results, which makes diagnosis more difficult.
Even with mild suspicion of sepsis, physicians often choose to provide empirical antibiotic therapy until blood cultures prove negative.
With the increasing attention paid to human breast milk, studies in recent years have attempted to explore the potential of probiotics in preventing sepsis. Although studies have shown that clinical trials worldwide are small, some randomized controlled trials have shown that probiotics can significantly reduce the risk of neonatal sepsis.
Treatment strategies
Treatment of neonatal sepsis usually involves intravenous fluids, supportive care, and antibiotics. A common antibiotic regimen is a combination of a beta-lactam antibiotic (usually ampicillin) and an aminoglycoside antibiotic. This treatment targets common pathogens in the maternal urinary tract, particularly group B Streptococcus, Enterobacter, and Listeria.
But due to the unique nature of neonates, the challenge for physicians is balancing the risks of antibiotic over-therapy with the potential consequences of sepsis.
The research report also pointed out that the overuse of antibiotics may affect the microbiome of newborn babies and may be associated with childhood asthma, food allergies and obesity.
Epidemiological trends
The incidence of early-onset sepsis has decreased since the 1990s, largely due to screening for group B Streptococcus. However, due to the weak immune system of newborns, the incidence and mortality of early-onset sepsis are higher in premature and low-birth-weight infants. Certain populations, such as mothers of low socioeconomic status and African Americans, are also at higher risk of infection.
Follow-up research and discussion
With the advancement of neonatal medical technology, the quiet evolution of neonatal sepsis has led many researchers to continuously explore new treatments. International clinical trials are ongoing in the hope of better understanding the use of probiotics and their potential benefits for neonatal health.
The medical community continues to explore neonatal sepsis and its potential solutions, but in this case, the challenges remain daunting.
Neonatal sepsis is a health issue that affects families and poses a significant health problem worldwide. In this evolving healthcare environment, how should we understand and address this troubling phenomenon?
