The ongoing challenge to prevent neonatal sepsis

摘要

In this issue of the journal, Williams et al. provide both good and potentially not so good news on the contribution that infections make to neonatal and infant mortality (1). The good news is that the absolute numbers of neonates and infants dying of infectious causes in the north of England fell significantly during the 21 years between 1988 and 2008. In particular, marked reductions were seen in Group B Streptococcus (GBS) during the neonatal period and in Meningococcus during the post-neonatal period. The not so good news was that the proportion of deaths related to infectious causes rose markedly from 12% to 15% during the 21-year study period. This was accompanied by a parallel increase in preterm infants, who accounted for 14% of total deaths in the first 7-year era beginning in 1998 and 38% in the third era ending in 2008. The specific organisms that rose most markedly were E. Coli and Candida sp, which were almost certainly secondary to the increased survival of extremely preterm infants.