Showing papers on "Procalcitonin published in 2024"

Neonatal Bacterial Sepsis and Meningitis

Abstract: Neonatal bacterial sepsis is a leading cause of morbidity and mortality of newborns. Evaluation of and treatment for neonatal sepsis are among the most common choices made by those caring for neonates. Neonatal sepsis is divided into early-onset (EOS), defined as occurring within 72 hours of birth, and late-onset (LOS), occurring after 72 hours. The most common pathogens associated with both EOS and LOS are Streptococcus agalactiae (GBS) and Escherichia coli. Listeria Monocytogenes and other gram-negative enteric bacilli are less common. Prematurity is the single greatest risk factor for neonatal sepsis. This chapter discusses the pathogenesis of both EOS and LOS in detail, including, but not limited to, common pathogens, clinical signs, diagnostic approach to neonates with suspected sepsis, treatment of sepsis, and neonatal meningitis. Infants with clinical signs and symptoms of sepsis should be evaluated and treated with antibiotics. A Neonatal Sepsis Calculator was developed to guide the evaluation and treatment of infants born at more than 34 weeks of gestation with maternal risk factors. Evaluation of sepsis must include a blood culture. CSF culture and analysis is added when there is a concern for meningitis, LOS, or a positive blood culture. Other testing, such as complete blood count, C-reactive protein, or procalcitonin, has not substantially improved neonatal sepsis prediction. Antibiotic treatment for infants with suspected sepsis generally includes ampicillin and an aminoglycoside. A third-generation cephalosporin is added when there is a concern for meningitis. Recent evidence supports careful consideration of the benefits of antibiotic therapy with the goals of antibiotic stewardship.