Neonatal sepsis in the very low birth weight preterm infants: part 2: review of definition, diagnosis and management

ABSTRACT

Having presented brief epidemiology of neonatal infection and patho-physiology of neonatal sepsis in the first part of this review we now address the difficulties in defining, diagnosing and treating neonatal sepsis. The objective of this part of the review is firstly, to highlight the reasons for lack of consensus on the definition of neonatal sepsis despite a number of international conferences of experts on the subject. Secondly, to discuss the increasing sophistication of available laboratory tests and why they all lack the certainty desired by the clinician and thirdly to discuss the various evidence based treatment modalities available to treat neonatal sepsis. It is suggested that pragmatic definition of sepsis as suggested by us should be adopted. Greater use of biomarkers and molecular tests should be made to diagnose sepsis early and accurately. Lastly, it is hoped to change the clinician's paradigm by using evidence based management care bundle/package that includes adjunctive immune-modulatory and host defence boosting drugs