Neonatal sepsis

Lancet. 2017 Oct 14;390(10104):1770-1780. doi: 10.1016/S0140-6736(17)31002-4. Epub 2017 Apr 20.


Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal flora, or postnatal acquisition from the hospital or community. The timing of exposure, inoculum size, immune status of the infant, and virulence of the causative agent influence the clinical expression of neonatal sepsis. Immunological immaturity of the neonate might result in an impaired response to infectious agents. This is especially evident in premature infants whose prolonged stays in hospital and need for invasive procedures place them at increased risk for hospital-acquired infections. Clinically, there is often little difference between sepsis that is caused by an identified pathogen and sepsis that is caused by an unknown pathogen. Culture-independent diagnostics, the use of sepsis prediction scores, judicious antimicrobial use, and the development of preventive measures including maternal vaccines are ongoing efforts designed to reduce the burden of neonatal sepsis.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Infective Agents / therapeutic use
  • Blood Component Transfusion
  • Chorioamnionitis
  • Cross Infection / complications
  • Cross Infection / drug therapy
  • Female
  • Free Radical Scavengers / therapeutic use
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • Granulocytes
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Infant, Newborn
  • Neonatal Sepsis / diagnosis*
  • Neonatal Sepsis / epidemiology
  • Neonatal Sepsis / etiology
  • Neonatal Sepsis / therapy*
  • Pentoxifylline / therapeutic use
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Risk Factors


  • Anti-Infective Agents
  • Free Radical Scavengers
  • Immunoglobulins, Intravenous
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Pentoxifylline