{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:14:38Z","timestamp":1791850478578,"version":"4.3.4"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"S 02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Neonatal sepsis is a major cause of worldwide morbidity and mortality. Blood cultures are considered the gold standard for diagnosis, but results are often delayed for 24 to 48\u2009hours, and sensitivity, although improved by modern techniques, such as automated blood cultures, is variable and affected by the bacterial load. For these reasons, empiric antibiotics are frequently administered to avoid potential devastating consequences of untreated sepsis. Unnecessary antibiotic treatment has been associated with increased mortality and other adverse outcomes; therefore, antibiotics should be discontinued as soon as sepsis has been ruled out. Negative cultures pose a challenge to clinicians, who must distinguish between real sepsis and sepsis-like conditions (noninfectious or viral) which do not require antibiotics. Focal infections with negative blood cultures do require antibiotic treatment. Ultra-low bacteremia, primary or secondary to recent antibiotic exposure, is often associated with negative cultures, and some consider a short course of empiric antibiotics sufficient for clearing of bacteremia. Biomarkers and molecular methods based on polymerase chain reaction are important add-ons to clinical signs or symptoms for establishing the diagnosis of sepsis. Other promising future potential adjuvants are metabolomics. Antibiotic stewardship should be implemented to avoid or discontinue unnecessary treatment. Prevention of infection still remains the most important step for dealing with neonatal sepsis.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1714079","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T18:34:07Z","timestamp":1599590047000},"page":"S18-S21","source":"Crossref","is-referenced-by-count":11,"special_numbering":"S","title":["Do Neonatal Infections Require a Positive Blood Culture?"],"prefix":"10.1055","volume":"37","author":[{"given":"Ruben","family":"Bromiker","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Elron","sequence":"additional","affiliation":[{"name":"Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petah Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Klinger","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/MOP.0000000000000338","article-title":"Adverse consequences of neonatal antibiotic exposure","volume":"28","author":"C M Cotten","year":"2016","journal-title":"Curr Opin Pediatr"},{"key":"ref2","article-title":"A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants","author":"J L Wynn","year":"2019","journal-title":"Pediatr Res"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S2352-4642(17)30023-8","article-title":"Defining sepsis (with or without positive blood cultures)","volume":"1","author":"J L Vincent","year":"2017","journal-title":"Lancet Child Adolesc Health"},{"key":"ref4","article-title":"Changing epidemiology and resistance patterns of pathogens causing neonatal bacteremia","author":"A Mintz","year":"2020","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1097\/00006454-199807000-00004","article-title":"Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants","volume":"17","author":"A A Fanaroff","year":"1998","journal-title":"Pediatr Infect Dis J"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3389\/fped.2018.00285","article-title":"Culture-negative early-onset neonatal sepsis - 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A validated prediction model","author":"O Goldberg","year":"2020","journal-title":"J Perinatol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13052-020-0807-7","article-title":"How could metabolomics change pediatric health?","volume":"46","author":"F Bardanzellu","year":"2020","journal-title":"Ital J Pediatr"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1714079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T18:34:52Z","timestamp":1599590092000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1714079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":15,"journal-issue":{"issue":"S 02","published-online":{"date-parts":[[2020,9,8]]},"published-print":{"date-parts":[[2020,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1714079","relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}