New trend in management of neonatal septicemia

Abstract

Neonatal sepsis or septicaemia is aclinical syndromecharacterized by systemicsigns of circulatory compromise(e.g. poor peripheral perfusion, pallor,hypotonia, poor responsiveness) caused byinvasion of the bloodstream by bacteria inthe first month of life. In the pre-antibioticera neonatal sepsis was usually fatal. Casefatality rates in antibiotic treated infantsnow range between 5% and 60% with thehighest rates reported from the lowest incomecountries. Neonatal sepsis may be categorized as early-onset or late-onset. Of newborns with early-onset sepsis, 85% present within 24 hours, 5% present at 24-48 hours, and a smaller percentage present within 48-72 hours. Onset is most rapid in premature neonates. The World Health Organization (WHO) estimates that 1milliondeaths per year (10% of all under-five mortality) are due to neonatalsepsis and that 42% of these deaths occur in the first week of life. In Egypt, septicemia is considered the single most important cause of death accounting for up to 50% of neonatal mortality. Neonate are highly susceptible to infectious diseases because of their immature immune systems and poorly developed skin barrier Neonates have a rapid and fulminant progression of septicemia disease, nonspecific clinical signs of infection, and difficult-to-interpret laboratory results including hematological and immunological biomarkers of infection and inflammation. Low birth-weight (preterm and small for gestational age) infants have even poorer functional immunity, and are especially at risk of sepsis.