Neonatal Sepsis: A Lancet Seminar on Diagnosis, Treatment, and the Urgent Need for Better Diagnostics
This Lancet review highlights neonatal sepsis as a leading cause of under-5 mortality globally, responsible with preterm birth for nearly 50% of all such deaths. The authors emphasize that progress has been hindered by the absence of a universal definition, the low sensitivity of blood culture as the reference standard, and the non-specific clinical presentation. The review calls for improved diagnostic techniques to guide targeted antimicrobial therapy and stresses that basic care improvements and quality initiatives remain the most impactful prevention strategies, particularly in low-resource settings.
The original study
Neonatal bacterial sepsis.
- Authors
- Strunk T, Molloy EJ, Mishra A, Bhutta ZA
- Journal
- Lancet (London, England)
- Type
- Journal Article, Review
- PMID
- 38944044
Original abstract
Neonatal sepsis remains one of the key challenges of neonatal medicine, and together with preterm birth, causes almost 50% of all deaths globally for children younger than 5 years. Compared with advances achieved for other serious neonatal and early childhood conditions globally, progress in reducing neonatal sepsis has been much slower, especially in low-resource settings that have the highest burden of neonatal sepsis morbidity and mortality. By contrast to sepsis in older patients, there is no universally accepted neonatal sepsis definition. This poses substantial challenges in clinical practice, research, and health-care management, and has direct practical implications, such as diagnostic inconsistency, heterogeneous data collection and surveillance, and inappropriate treatment, health-resource allocation, and education. As the clinical manifestation of neonatal sepsis is frequently non-specific and the current diagnostic standard blood culture has performance limitations, new improved diagnostic techniques are required to guide appropriate and warranted antimicrobial treatment. Although antimicrobial therapy and supportive care continue as principal components of neonatal sepsis therapy, refining basic neonatal care to prevent sepsis through education and quality improvement initiatives remains paramount.