Editorial Published on October 14, 2021

 

Neonatal Sepsis – Are We Faring Better?

Jayasree C

 

a. Editor in Chief, For the editorial team of “Fetus and Newborn”

 

Dear colleagues,

Greetings from the editor’s desk.

Thanks to all my seniors and editorial board, the first issue was well received by the neonatologists and paediatricians. In this second issue, we are extremely happy to include a research article from the nursing team, who form the backbone of neonatal care. The editorial team encourages and invites more contribution from the nursing fraternity which will of use to nursing and physician community too.

As we all know neonatal sepsis is one of the major causes of neonatal morbidity and mortality in India and  one of the commonly encountered conditions by neonatologists. Delay in the diagnosis and treatment of sepsis can lead to adverse outcome. How can we can bring in the best outcome is often the thought of the treating physician. Do we still rely on the conventional method of clinical and microbiological tools? Early detection and treatment, being the best methods to improve survival, what all tools do we have? The gold standard for establishing a diagnosis of neonatal sepsis is blood culture. However, several factors, including the small blood volumes obtained from neonates, the presence of low or intermittent bacteremia, as well as maternal intrapartum antimicrobial exposure, can make the confirmation of sepsis in a neonate a diagnostic challenge.

Clinical manifestations in neonates are not often a reliable indicator of illness. Reduced heart rate variability and decelerations are useful signs. Conventional microbiological tools are time consuming. Bio markers like CRP and pro calcitonin are useful neonatal diagnostic tools with varied sensitivity and specificity as per different studies.1

Metabolomics, gene expression profiling and molecular diagnostics by way of PCR etc are also increasingly used. Better understanding of the predictive value of the diagnostic tools will also aid the physicians in making a more informed interpretation of the results to guide management. In this edition we have a review article on “The role of biomarkers in neonatal sepsis” by Dr. P.M.C Nair, which is very relevant in our daily practice.

Let us hope that newer diagnostic tools and treatment modalities will bring in best outcomes in near future.

References

  1. Sharma D, Farahbakhsh N, Shastri S, Sharma P. Biomarkers for diagnosis of neonatal sepsis: a literature review. J Matern Fetal Neonatal Med. 2018 Jun;31(12):1646–59.
    [Pubmed] | [Crossref]