Bacterial Infections of the Newborn [Article in Croatian]

Abstract

The incidence of neonatal sepsis is from 0.1 to 1%. In the group of neonatal sepsis we can distinguish early onset disease that occurs from birth to 5 days of life, and late onset disease that occurs after fifth day of life. Some authors distinguish very late onset disease, which occurs later in life of premature infants with very short gestational age. The causes of early onset disease originate from perinatal period, with infection starting prenataly or intrapartaly. Most common bacterial causes of early onset disease are group B streptococci and Escherichia coli. The causes of late and very late onset disease are in hospital environ­ment. The risk factors for development of neonatal sepsis are: premature labour, poor socioeconomic sur­rounding, premature rupture of the membranes, chorioamnionitis, and critically ill infant, surgical, invasive diagnostic or therapeutic procedures and long term stay in ICU etc. Clinical presentation is unspecific and includes a lot of signs. Laboratory findings of neonatal sepsis are leucocytosis with left-shifted differential, increased CRP and other mediators of inflammation (IL6, IL8, TNF, procalcitonin) and positive hemocul­tures. Differential diagnosis of neonatal sepsis includes galactosemia and organic acidurias. Other diseases that can present wit similar clinical findings are hypoplastic left heart syndrome, coarctation of the aorta, so the correct diagnosis can sometimes be difficult. The neonatal sepsis should be treated in the neonatal intensive care units especially if there are preterm infants involved. Treatment of neonatal sepsis and ac­companied infections is complicated and in many cases result in higher morbidity and mortality.