{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:03:32Z","timestamp":1790420612819,"version":"4.1.0"},"reference-count":21,"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>Despite continued advances and developments in neonatal medicine, neonatal sepsis is the third leading cause of neonatal mortality and a major public health problem, especially in developing countries. Sepsis accounts for mortality for almost 50% of global children under 5 years of age.<\/jats:p><jats:p>Over the past 50 years, there have been many advances in the diagnosis, prevention, and treatment of neonatal infections. The diagnostic advances include better culture techniques that permit more rapid confirmation of the diagnosis, advent of polymerase chain reaction (PCR) to rapidly diagnose viral infections, use of biologic markers indicating evidence of infection, and a better understanding of immunoglobulin markers of infection. From a therapeutic stand point, there have been a variety of antibiotics, antifungals, and antiviral agents, better approaches to prevent sepsis, specific immunotherapy, for example, respiratory syncytial virus (RSV); bundled approach to prevention of deep-line infection and better antibiotic stewardship, leading to earlier discontinuation of antibiotic therapy.<\/jats:p><jats:p>Hand hygiene remains the benchmark and gold standard for late-onset sepsis prevention. The challenge has been that each decade, newer resistant bacteria dominate as the cause of sepsis and newer viruses emerge, for example, human immunodeficiency virus, zika virus, and novel coronavirus disease 2019.<\/jats:p><jats:p>Future treatment options might include stem cell therapy, other antimicrobial protein and peptides, and targeting of pattern recognition receptors in an effort to prevent and\/or treat sepsis in this vulnerable population. Also, the microbiome of premature infants has a smaller proportion of beneficial bacteria and higher numbers of pathogenic bacteria compared with term infants, likely owing to higher frequencies of cesarean sections, antibiotic use, exposure to the hospital environment, and feeding nonhuman milk products. Modifying the microbiome with more mother's milk and shorter duration of antibiotics in noninfected babies should be a goal.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1715584","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T22:34:07Z","timestamp":1599604447000},"page":"S5-S9","source":"Crossref","is-referenced-by-count":13,"special_numbering":"S","title":["Advances in Neonatal Infections"],"prefix":"10.1055","volume":"37","author":[{"given":"Avroy A.","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ajog.2018.11.1084","article-title":"Rediscovering Ignaz Philipp Semmelweis (1818-1865)","volume":"220","author":"N Kadar","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1136\/archdischild-2019-317110","article-title":"Neonatal early onset sepsis in Middle Eastern countries: a systematic review","volume":"105","author":"N Khalil","year":"2020","journal-title":"Arch Dis Childl"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"F327","DOI":"10.1136\/archdischild-2018-315412","article-title":"Challenges and opportunities for antibiotic stewardship among preterm infants","volume":"104","author":"S Mukhopadhyay","year":"2019","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"e20182896","DOI":"10.1542\/peds.2018-2896","article-title":"Management of neonates born at \u226434 6\/7 weeks' gestation with suspected or proven early-onset bacterial sepsis","volume":"142","author":"K M Puopolo","year":"2018","journal-title":"Pediatrics"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000454668","article-title":"The \u201cgolden age\u201d of probiotics: a systematic review and meta-analysis of randomized and observational studies in preterm infants","volume":"112","author":"E Dermyshi","year":"2017","journal-title":"Neonatology"},{"issue":"06","key":"ref6","first-page":"CD007137","article-title":"Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants","volume":"6","author":"M Pammi","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta22740","article-title":"The ELFIN trial investigators group enteral lactoferrin to prevent infection for very preterm infants","volume":"22","author":"J Griffiths","year":"2018","journal-title":"The ELFIN RCT Health Technol Assess"},{"issue":"S 02","key":"ref8","doi-asserted-by":"crossref","first-page":"S152","DOI":"10.1093\/cid\/cix655","article-title":"Risk of early-onset neonatal group B streptococcal disease with maternal colonization worldwide: systematic review and meta-analyses","volume":"65","author":"N J Russel","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"S 04","key":"ref9","doi-asserted-by":"crossref","first-page":"D20","DOI":"10.1016\/j.vaccine.2012.11.056","article-title":"Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: experience in the United States and implications for a potential group B streptococcal vaccine","volume":"31","author":"S J Schrag","year":"2013","journal-title":"Vaccine"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s00431-017-2888-x","article-title":"A quality improvement initiative to reduce central line infection in neonates using checklists","volume":"176","author":"J E Taylor","year":"2017","journal-title":"Eur J Pediatr"},{"key":"ref11","volume-title":"Committee on Infectious Diseases: Syphilis. 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