Abstract:Neonatal sepsis, as a significant cause of various complications and adverse outcomes in neonates, remains a serious health burden both domestically and internationally. Strategies such as antibiotic prophylaxis during delivery, the utilization of early-onset sepsis risk calculators, and quality improvement initiatives in neonatal wards are beneficial in alleviating the disease burden of neonatal sepsis. This paper provides a review of the epidemiology, risk factors, and recent advances in clinical management of neonatal sepsis.
Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review[J]. Lancet Respir Med, 2018, 6(3): 223-230. PMID: 29508706. DOI: 10.1016/S2213-2600(18)30063-8.
Chen XC, Yang YF, Wang R, et al. Epidemiology and microbiology of sepsis in the mainland of China in the first decade of the 21st century[J]. Int J Infect Dis, 2015, 31: 9-14. PMID: 25455799. DOI: 10.1016/j.ijid.2014.11.027.
Li JY, Chen SQ, Yan YY, et al. Identification and antimicrobial resistance of pathogens in neonatal septicemia in China: a meta-analysis[J]. Int J Infect Dis, 2018, 71: 89-93. PMID: 29689386. DOI: 10.1016/j.ijid.2018.04.794.
Cailes B, Kortsalioudaki C, Buttery J, et al. Epidemiology of UK neonatal infections: the neonIN infection surveillance network[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(6): F547-F553. PMID: 29208666. DOI: 10.1136/archdischild-2017-313203.
Born S, Dame C, Matth?us-Kr?mer C, et al. Epidemiology of sepsis among children and neonates in Germany: results from an observational study based on nationwide diagnosis-related groups data between 2010 and 2016[J]. Crit Care Med, 2021, 49(7): 1049-1057. PMID: 33729720. DOI: 10.1097/CCM.0000000000004919.
Schrag SJ, Farley MM, Petit S, et al. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014[J]. Pediatrics, 2016, 138(6): e20162013. PMID: 27940705. DOI: 10.1542/peds.2016-2013.
Singh T, Barnes EH, Isaacs D, et al. Early-onset neonatal infections in Australia and New Zealand, 2002-2012[J]. Arch Dis Child Fetal Neonatal Ed, 2019, 104(3): F248-F252. PMID: 29588295. DOI: 10.1136/archdischild-2017-314671.
Sgro M, Shah PS, Campbell D, et al. Early-onset neonatal sepsis: rate and organism pattern between 2003 and 2008[J]. J Perinatol, 2011, 31(12): 794-798. PMID: 21527901. DOI: 10.1038/jp.2011.40.
Gao K, Fu J, Guan X, et al. Incidence, bacterial profiles, and antimicrobial resistance of culture-proven neonatal sepsis in South China[J]. Infect Drug Resist, 2019, 12: 3797-3805. PMID: 31819560. PMCID: PMC6899077. DOI: 10.2147/IDR.S223597.
Lu Q, Zhou M, Tu Y, et al. Pathogen and antimicrobial resistance profiles of culture-proven neonatal sepsis in Southwest China, 1990-2014[J]. J Paediatr Child Health, 2016, 52(10): 939-943. PMID: 27500793. DOI: 10.1111/jpc.13278.
Yu YQ, He XR, Wan LJ, et al. Etiology, antimicrobial resistance, and risk factors of neonatal sepsis in China: a systematic review and meta-analysis from data of 30 years[J]. J Matern Fetal Neonatal Med, 2022, 35(25): 7541-7550. PMID: 34470123. DOI: 10.1080/14767058.2021.1951217.
Villamor-Martinez E, Lubach GA, Rahim OM, et al. Association of histological and clinical chorioamnionitis with neonatal sepsis among preterm infants: a systematic review, meta-analysis, and meta-regression[J]. Front Immunol, 2020, 11: 972. PMID: 32582153. PMCID: PMC7289970. DOI: 10.3389/fimmu.2020.00972.
Strunk T, Doherty D, Jacques A, et al. Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants[J]. Pediatrics, 2012, 129(1): e134-e141. PMID: 22157134. DOI: 10.1542/peds.2010-3493.
Hei MY, Zhang XC, Gao XY, et al. Catheter-related infection and pathogens of umbilical venous catheterization in a neonatal intensive care unit in China[J]. Am J Perinatol, 2012, 29(2): 107-114. PMID: 22131046. DOI: 10.1055/s-0031-1295650.
Shalabi M, Adel M, Yoon E, et al. Risk of infection using peripherally inserted central and umbilical catheters in preterm neonates[J]. Pediatrics, 2015, 136(6): 1073-1079. PMID: 26574592. DOI: 10.1542/peds.2015-2710.
Puopolo KM, Lynfield R, Cummings JJ, et al. Management of infants at risk for group B streptococcal disease[J]. Pediatrics, 2019, 144(2): e20191881. PMID: 31285392. DOI: 10.1542/peds.2019-1881.
Nanduri SA, Petit S, Smelser C, et al. Epidemiology of invasive early-onset and late-onset group B streptococcal disease in the United States, 2006 to 2015: multistate laboratory and population-based surveillance[J]. JAMA Pediatr, 2019, 173(3): 224-233. PMID: 30640366. PMCID: PMC6439883. DOI: 10.1001/jamapediatrics.2018.4826.
Huang J, Lin XZ, Zhu Y, et al. Epidemiology of group B streptococcal infection in pregnant women and diseased infants in the mainland of China[J]. Pediatr Neonatol, 2019, 60(5): 487-495. PMID: 31445795. DOI: 10.1016/j.pedneo.2019.07.001.
Puopolo KM, Benitz WE, Zaoutis TE, et al. Management of neonates born at ≥35 0/7 weeks' gestation with suspected or proven early-onset bacterial sepsis[J]. Pediatrics, 2018, 142(6): e20182894. PMID: 30455342. DOI: 10.1542/peds.2018-2894.
He Y, Chen J, Liu Z, et al. Efficacy and safety of applying a neonatal early-onset sepsis risk calculator in China[J]. J Paediatr Child Health, 2020, 56(2): 237-243. PMID: 31328848. DOI: 10.1111/jpc.14572.
Kuzniewicz MW, Puopolo KM, Fischer A, et al. A quantitative, risk-based approach to the management of neonatal early-onset sepsis[J]. JAMA Pediatr, 2017, 171(4): 365-371. PMID: 28241253. DOI: 10.1001/jamapediatrics.2016.4678.
Achten NB, Klingenberg C, Benitz WE, et al. Association of use of the neonatal early-onset sepsis calculator with reduction in antibiotic therapy and safety: a systematic review and meta-analysis[J]. JAMA Pediatr, 2019, 173(11): 1032-1040. PMID: 31479103. PMCID: PMC6724419. DOI: 10.1001/jamapediatrics.2019.2825.
Carola D, Vasconcellos M, Sloane A, et al. Utility of early-onset sepsis risk calculator for neonates born to mothers with chorioamnionitis[J]. J Pediatr, 2018, 195: 48-52.e1. PMID: 29275925. DOI: 10.1016/j.jpeds.2017.11.045.
Achten NB, Visser DH, Tromp E, et al. Early onset sepsis calculator implementation is associated with reduced healthcare utilization and financial costs in late preterm and term newborns[J]. Eur J Pediatr, 2020, 179(5): 727-734. PMID: 31897840. PMCID: PMC7160215. DOI: 10.1007/s00431-019-03510-9.
van Hasselt TJ, McDermott H, Surana P, et al. Impact of neonatal sepsis calculator in West Midlands (UK)[J]. Arch Dis Child Fetal Neonatal Ed, 2021, 106(5): 568-569. PMID: 33293276. DOI: 10.1136/archdischild-2020-320862.
Strunk T, Buchiboyina A, Sharp M, et al. Implementation of the neonatal sepsis calculator in an Australian tertiary perinatal centre[J]. Neonatology, 2018, 113(4): 379-382. PMID: 29514161. DOI: 10.1159/000487298.
Mukherjee A, Davidson L, Anguvaa L, et al. Nice neonatal early onset sepsis guidance: greater consistency, but more investigations, and greater length of stay[J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(3): F248-F249. PMID: 25079114. DOI: 10.1136/archdischild-2014-306349.
Goel N, Shrestha S, Smith R, et al. Screening for early onset neonatal sepsis: nice guidance-based practice versus projected application of the Kaiser Permanente sepsis risk calculator in the UK population[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(2): 118-122. PMID: 31296696. DOI: 10.1136/archdischild-2018-316777.
Morris R, Jones S, Banerjee S, et al. Comparison of the management recommendations of the Kaiser Permanente neonatal early-onset sepsis risk calculator (SRC) with nice guideline CG149 in infants ≥34 weeks' gestation who developed early-onset sepsis[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(6): 581-586. PMID: 32170032. DOI: 10.1136/archdischild-2019-317165.
Bowen JR, Callander I, Richards R, et al. Decreasing infection in neonatal intensive care units through quality improvement[J]. Arch Dis Child Fetal Neonatal Ed, 2017, 102(1): F51-F57. PMID: 27142638. DOI: 10.1136/archdischild-2015-310165.
Zhou Q, Lee SK, Hu XJ, et al. Successful reduction in central line-associated bloodstream infections in a Chinese neonatal intensive care unit[J]. Am J Infect Control, 2015, 43(3): 275-279. PMID: 25728154. DOI: 10.1016/j.ajic.2014.12.001.
Wang W, Zhao C, Ji Q, et al. Prevention of peripherally inserted central line-associated blood stream infections in very low-birth-weight infants by using a central line bundle guideline with a standard checklist: a case control study[J]. BMC Pediatr, 2015, 15: 69. PMID: 26084807. PMCID: PMC4470111. DOI: 10.1186/s12887-015-0383-y.
Payne V, Hall M, Prieto J, et al. Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis[J]. Arch Dis Child Fetal Neonatal Ed, 2018, 103(5): F422-F429. PMID: 29175985. DOI: 10.1136/archdischild-2017-313362.
Zaka N, Alexander EC, Manikam L, et al. Quality improvement initiatives for hospitalised small and sick newborns in low- and middle-income countries: a systematic review[J]. Implement Sci, 2018, 13(1): 20. PMID: 29370845. PMCID: PMC5784730. DOI: 10.1186/s13012-018-0712-2.