Journal Article

Neonatal sepsis: within and beyond China

Basmaci, Romain, Dong, Ying, Sun, Bo, Mercier, Jean-Christophe, Titomanlio, Luigi

2020

Overview

Sepsis remains a significant cause of neonatal morbidity and mortality in China. A better understanding of neonatal sepsis in China as compared with other industrialized and non-industrialized countries may help optimize neonatal health care both regionally and globally. Literature cited in this review was retrieved from PubMed using the keywords \"neonatal sepsis,\" \"early-onset (EOS)\" and \"late-onset (LOS)\" in English, with the focus set on population-based studies. This review provides an updated summary regarding the epidemiology, pathogen profile, infectious work-up, and empirical treatment of neonatal sepsis within and beyond China. The incidence of neonatal EOS and the proportion of Group B Streptococcus (GBS) within pathogens causing EOS in China seem to differ from those in developed countries, possibly due to different population characteristics and intrapartum/postnatal health care strategies. Whether to adopt GBS screening and intrapartum antibiotic prophylaxis in China remains highly debatable. The pathogen profile of LOS in China was shown to be similar to other countries. However, viruses as potential pathogens of neonatal LOS have been underappreciated. Growing antimicrobial resistance in China reflects limitations in adapting antibiotic regimen to local microbial profile and timely cessation of treatment in non-proven bacterial infections. This review stresses that the local epidemiology of neonatal sepsis should be closely monitored in each institution. A prompt and adequate infectious work-up is critically important in diagnosing neonatal sepsis. Adequate and appropriate antibiotic strategies must be overemphasized to prevent the emergence of multi-resistant bacteria in China.

• Publisher: Lippincott Williams & Wilkins,Lippincott Williams & Wilkins Ovid Technologies,Service de Pédiatrie-Urgences, AP-HP, H?pital Louis-Mourier, 92700 Colombes, France%Pediatric Emergency Department, Robert Debre University Hospital, 75019 Paris, France%Departments of Pediatrics and Neonatology, Children’s Hospital of Fudan University, Shanghai 201102, China%Medical University of Paris, 75018 Paris, France,Department of Neonatology, Children’s Hospital of Fudan University, Shanghai 201102, China%Université de Paris, IAME, INSERM, 75018 Paris, France,Chinese Medical Association,Wolters Kluwer
• Subject: Anti-Bacterial Agents - therapeutic use / Antibiotics / China - epidemiology / Developing countries / Disease / E coli / Fatalities / Female / Hospitals / Humans / Incidence / Industrialized nations / Infant, Newborn / Infections / LDCs / Life Sciences / Mortality / Neonatal Sepsis - diagnosis / Neonatal Sepsis - drug therapy / Neonatal Sepsis - epidemiology / Newborn babies / Pathogens / Population / Population-based studies / Pregnancy / Pregnancy Complications, Infectious - drug therapy / Prevention / Quantitative Methods / Review / Sepsis / Sepsis - diagnosis / Sepsis - drug therapy / Sepsis - epidemiology / Streptococcal Infections - drug therapy / Streptococcus agalactiae / Streptococcus infections / Vagina / Womens health