Identifying life threatening serious bacterial infections in neonates and young infants.

Despite advances in neonatal care, infection remains a leading cause of morbidity and mortality in neonates worldwide. Neonates (0-28 days) and young infants (29-90 days) have unique vulnerabilities to infection due to their immature immune systems and incomplete barriers to invasion (Huppler et al. 2010). Most children with infections recover fully, but some febrile children have Serious Bacterial Infections (SBIs), such as meningitis, pneumonia, urinary tract infection, bacterial gastroenteritis, osteomyelitis, and bacteremia. These patients are at high risk for adverse outcomes (Ishimine P. 2013).


Clinical examination alone is often not sufficiently accurate for detecting SBI in these age groups. Therefore, although the rate of SBI in febrile neonates and young infants has been reported to be between 8.5% and 12%, most of them undergo full sepsis evaluation and receive antibiotic therapy (Huppler et al. 2010). This approach has significant disadvantages including unnecessary hospitalizations and invasive diagnosis (lumbar puncture), increased risk of nosocomial infections, injudicious use of broad-spectrum antibiotics, adverse effects of antibiotics, and contributes to the emergence of resistant bacteria (Lieu et al. 1992, Mintegi et al. 2013).


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