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Advancements in Neonatal Sepsis Diagnosis and Treatment – Neonatal Disorders

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class="site-content" id="content"> <div class="content-area" id="primary"> <main class="site-main" id="main"> <article id="post-77" class="post-77 post type-post status-publish format-standard has-post-thumbnail hentry category-neonatal-sepsis tag-antibiotic-treatment tag-bacterial-infection tag-c-reactive-protein tag-fungi-septicaemia tag-icrovascular-thrombosis tag-inflammatory-disorders tag-leukocyte tag-neonatal-sepsis tag-novel-treatment tag-serological-tests" itemtype="https://schema.org/CreativeWork" itemscope> <div class="inside-article"> <div class="featured-image page-header-image-single "> <img width="2560" height="1340" src="https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-scaled.jpg" class="attachment-full size-full" alt="" itemprop="image" decoding="async" fetchpriority="high" srcset="https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-scaled.jpg 2560w, https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-300x157.jpg 300w, https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-1024x536.jpg 1024w, https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-768x402.jpg 768w, https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-1536x804.jpg 1536w, https://neonataldisorders.com/archive/wp-content/uploads/2024/09/image-_27_-min-2048x1072.jpg 2048w" sizes="(max-width: 2560px) 100vw, 2560px" /> </div> <header class="entry-header"> <h1 class="entry-title" itemprop="headline">Advancements in Neonatal Sepsis Diagnosis and Treatment</h1> <div class="entry-meta"> <span class="posted-on"><time class="entry-date published" datetime="2024-09-10T18:09:55+05:30" itemprop="datePublished">September 10, 2024</time></span> <span class="byline">by <span class="author vcard" itemprop="author" itemtype="https://schema.org/Person" itemscope><a class="url fn n" href="https://neonataldisorders.com/archive/author/neonataldisorders/" title="View all posts by neonataldisorders" rel="author" itemprop="url"><span class="author-name" itemprop="name">neonataldisorders</span></a></span></span> </div> </header> <div class="entry-content" itemprop="text"> <p><span style="font-weight: 400;">Neonatal sepsis still breeds major issues in neonatal practice, particularly in the developed world, due to its added contributions to neonatal morbidity and mortality. Thus, the diagnosis as well as the management of neonatal sepsis remain a health problem with many enumerations, even in the context of improvements in medical science. Over the years, researchers and clinicians have made many discoveries influenced by modern trends, providing new approaches to enhance the outcomes of neonates diagnosed with sepsis. The focus of this article is to identify the new trends in the diagnosis and management of neonatal sepsis, including the newer markers used in diagnosing the condition, teamwork in the management of the disease, and trends in the initial management of the neonate with sepsis. </span></p> <h3><b>Introduction to Neonatal Sepsis </b></h3> <p><span style="font-weight: 400;">Neonatal sepsis is an infection in a newborn that results in SIRS due to bacteria, viruses, or fungi. Septicemia is the main one. According to the time of onset, the condition can be divided into early-onset sepsis (EOS), which is within the first 72 hours of life, and late-onset sepsis (LOS). It has been discovered that early diagnosis of stroke and accurate identification of its type play a central role in its management and favorable outcomes. Nevertheless, it is imperative to understand that the clinical manifestation of neonatal sepsis is sometimes nonspecific, and therefore the babies’ diagnosis may at times be complicated. Newer developments in diagnostic methods and curative procedures have presented a prospect for making improvements in these aspects in neonates and thus improving results. </span></p> <h3><b>Emerging Diagnostic Markers</b></h3> <h4><b>C-Reactive Protein (CRP) </b></h4> <p><span style="font-weight: 400;">C-reactive protein (CRP) is an acute-phase protein that rises with inflammation but lacks specificity for particular diseases. Significant studies have also been done where it has been used in diagnosing neonatal sepsis together with other tests. The patient’s serial quantitative CRP level, which should be taken 24 hours after the onset of symptoms and then at 12 to 24-hour intervals, is a sensitive and reliable marker in diagnosing sepsis. The estimation of CRP is useful in removing the perception of certain infant infections and potential antibiotic overuse by withdrawing antibiotics where necessary. Leukocyte Indices </span></p> <p><span style="font-weight: 400;">Some of the components that are frequently employed in the assessment of neonatal sepsis are the leukocyte count together with the neutrophil count, as well as the I/T ratio. While these indices may offer great help for the assessment, their sensitivity and specificity may be different. The data have also indicated that the addition of leukocyte indices to other markers like CRP significantly improves diagnostic probabilities. </span></p> <h4><b>Procalcitonin (PCT) </b></h4> <p><span style="font-weight: 400;">Another biomarker worthy of note is procalcitonin in the diagnosis of neonatal sepsis. It is synthesized under conditions of bacterial infection and has proven to have higher specificity in comparison with CRP. In bacterial sepsis, PCT is found to be elevated, which distinguishes bacterial infection from viral diseases and other inflammatory disorders. Thus, the inclusion of PCT measurements in the diagnostic algorithm can enhance sepsis recognition and the management of antibiotic treatment. </span></p> <h4><b>Advanced Serological Tests </b></h4> <p><span style="font-weight: 400;">Current advancements in serological testing have enhanced the chances of early detection of infections in pregnancy, such as the cytomegalovirus (CMV). Assays like IgG avidity, IgM immunoblotting, and immunologic neutralization assays can accurately establish the antenatal immune status of a woman and pinpoint those who are in their first trimester, hence at a higher risk of transmitting the infection to their offspring. These tests can be run early during pregnancy, enabling early management and thereby minimizing congenital infections. </span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Yearwise Publication Trend on <b>“<a href="https://neonataldisorders.com/publication-trends/index/neonatal sepsis" target="_blank" title="neonatal sepsis - yearwise publication trends">neonatal sepsis</a>”</b></h2> </div> </div><div class="results-container"><div class="chart-block" style="padding:15px;"> <div class="left"> <div id="results" class="results"></div> </div> <div class="right"> <div class="chart-container"><canvas id="publicationChart"></canvas></div> </div> <div class="keywordsdiv"> <div style="text-align:center;"><b>Find publication trends on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-stats"></span> </div> </div></div></div><div class="inside-article"><style> table { margin: 0 0 1.5em; 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if (!statistics || Object.keys(statistics).length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var tableHTML = `<div class='pub-scroll'> <table class='tablediv' border='1' cellspacing='0' cellpadding='0'> <tr> <th>Year</th> <th>Publication Count</th> </tr>`; Object.entries(statistics).sort(([yearA], [yearB]) => yearB - yearA).forEach(([year, count]) => { const displayCount = count === 0 ? 'NA' : count; tableHTML += ` <tr> <td>${year}</td> <td>${displayCount}</td> </tr> `; }); tableHTML += '</table></div>'; resultsContainer.innerHTML = tableHTML; } function displayLineChart(statistics) { var years = Object.keys(statistics); var counts = Object.values(statistics); var ctx = document.getElementById('publicationChart').getContext('2d'); // Destroy existing chart instance if it exists if (chart !== null) { chart.destroy(); } // Create a new chart instance chart = new Chart(ctx, { type: 'line', data: { labels: years, datasets: [{ label: 'Publication Counts', data: counts, fill: false, borderColor: 'rgba(75, 192, 192, 1)', tension: 0.1 }] }, options: { scales: { y: { beginAtZero: true } }, plugins: { legend: { display: true, position: 'top' } } } }); } function displayKeywordStats(keywords) { var resultsContainer = document.getElementById('keyword-stats'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach((key, index) => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://neonataldisorders.com/publication-trends/index/${key_replace}" target="_blank" title="${key} - yearwise publication trends">${key}</a>`; if (index < keywords.length - 1) { keywordHTML += ', '; } }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var statistics = { "2014": 201, "2015": 192, "2016": 275, "2017": 345, "2018": 344, "2019": 557, "2020": 756, "2021": 900, "2022": 1035, "2023": 1613, "2024": 554 }; var keywordsArray = ["Neonatal sepsis","fungi Septicaemia","C-Reactive Protein","leukocyte","bacterial infection","inflammatory disorders","antibiotic treatment","Serological Tests","Novel Treatment","microvascular thrombosi"]; displayResults(statistics); displayLineChart(statistics); displayKeywordStats(keywordsArray); </script></p> <h3><b>Multidisciplinary Approaches</b></h3> <h4><b>Multidisciplinary Sepsis Protocols</b></h4> <p><span style="font-weight: 400;">Thus, it has been evidenced that multidisciplinary sepsis protocols enhance the outcomes of neonates with sepsis. Such protocols include a symbiotic partnership with neonatologists, pediatricians, nurses, and other related staff. Multidisciplinary protocols contain specific diagnostic and therapeutic actions so that effective and correct interventions can be performed in due time. These protocols consist of sepsis identification at the initial stage, antibiotic administration, fluid balance, and the condition of the infant. </span></p> <h4><b>Early Goal-Directed Therapy (EGDT) </b></h4> <p><span style="font-weight: 400;">It is a well-evidenced therapy aimed at stabilizing the cardiovascular status of septic patients and involves prompt identification of sepsis-associated indicators. In neonatal sepsis, EGDT includes monitoring of vital signs, fluid bolus administration, and vasopressor administration for perfusion pressure. Researchers have shown that EGDT can be beneficial in decreasing the mortality rates in neonates with septic shock and enhancing their clinical status by avoiding the development of cardiovascular complications as well as organ failure. </span></p> <h4><b>Special care baby units (SCBUs) </b></h4> <p><span style="font-weight: 400;">The functions of NICUs in the management of neonatal sepsis cannot be overemphasized. NICUs have sophisticated monitoring and life support tools necessary for handling severe sepsis and septic shock. The qualified staff of healthcare attendants and the availability of specialized equipment in NICUs guarantee the neonates the best care. Thus, timely surveillance of the unstable condition of an infant and a swift reaction to alterations in her state are critical for raising rates of survival and diminishing adverse outcomes. </span></p> <h3><b>Novel Treatment Protocols</b></h3> <h4><b>Antimicrobial Therapy</b></h4> <p><span style="font-weight: 400;">Appropriate initiation of antimicrobial therapy is the cornerstone of the management of neonatal sepsis. Selection and dosages of antibiotics differ according to the probable infected pathogens and their level of resistance. Empiric antibiotic therapy entails the use of both ampicillin and gentamicin to target a broad range of bacteria. However, the uncompromising resistance of common pathogens calls for continuous changes to the antibiotic guidelines according to the resistance profile in that region. </span></p> <h4><b>Activated Protein C (APC)</b></h4> <p><span style="font-weight: 400;">Since then, other activated protein C (APC) has also been proposed as an adjunctive therapy in neonatal sepsis. Reviewing the literature on APC reveals that it possesses anti-inflammatory as well as anticoagulant effects that physiologically alter the host response to bacterial infection. Clinical studies have shown that APC can decrease mortality in septic patients by lessening the severity of inflammation and microvascular thrombosis. Even though the role of APC in neonates has not yet been thoroughly researched, it can be considered an effective treatment for neonatal sepsis. </span></p> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Recent Publications on <b>“<a href="https://neonataldisorders.com/recent-publications/index/neonatal sepsis" target="_blank" rel="noopener" title="neonatal sepsis - yearwise publication list">neonatal sepsis</a>”</b></h2> </div> </div> <div class="pb-main"><div class="article-scroll"><div id="results_recent" class="results"></div></div><div class="keywordsdiv" style="margin: 0px 15px;margin-top:20px;"> <div style="text-align:center;"><b>Find publications on relevant topics</b> </div> <span class="gp-icon icon-tags"><svg viewBox="0 0 512 512" aria-hidden="true" xmlns="http://www.w3.org/2000/svg" width="1em" height="1em"><path d="M20 39.5c-8.836 0-16 7.163-16 16v176c0 4.243 1.686 8.313 4.687 11.314l224 224c6.248 6.248 16.378 6.248 22.626 0l176-176c6.244-6.244 6.25-16.364.013-22.615l-223.5-224A15.999 15.999 0 00196.5 39.5H20zm56 96c0-13.255 10.745-24 24-24s24 10.745 24 24-10.745 24-24 24-24-10.745-24-24z"></path><path d="M259.515 43.015c4.686-4.687 12.284-4.687 16.97 0l228 228c4.686 4.686 4.686 12.284 0 16.97l-180 180c-4.686 4.687-12.284 4.687-16.97 0-4.686-4.686-4.686-12.284 0-16.97L479.029 279.5 259.515 59.985c-4.686-4.686-4.686-12.284 0-16.97z"></path></svg></span> <span id="keyword-papers"></span> </div></div></div><div class="inside-article"> <style> .pb-main{ border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .author-main { border: solid 1px #ccc; border-top: none; margin-bottom: 20px; padding-bottom: 25px; background:#fff; } .publication-block { padding: 10px; margin-bottom: 10px; background-color: #f9f9f9; text-align: left; background: #FFF; border-bottom: solid 1px #ccc; margin-left: 15px; margin-right: 15px; } .publication-block h3 { margin: 0 0 10px; color: #000!important; } .publication-block a { font-size: 16px !important; line-height: 1em; font-weight: 600; text-transform: none; color: #000; padding: 0px; } .publication-block a:hover{ color: #227cdc; text-decoration:underline; } .article-scroll { max-height: 445px; overflow-y: auto; overflow-x: hidden; } ::-webkit-scrollbar-track { -webkit-box-shadow: inset 0 0 6px rgba(0,0,0,0.3); background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar { width: 6px; background-color: #efefef; border-radius:30px; } ::-webkit-scrollbar-thumb { background-color: #ababab; 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publicationBlock.innerHTML = publicationHTML; resultsContainer.appendChild(publicationBlock); }); } function displayKeywordPapers(keywords) { var resultsContainer = document.getElementById('keyword-papers'); resultsContainer.innerHTML = ''; if (!keywords || keywords.length === 0) { resultsContainer.innerHTML = '<p>No data found.</p>'; return; } var keywordHTML = ''; keywords.forEach((key, index) => { let key_replace = key.replace(/ /g, '-'); key_replace = key_replace.toLowerCase(); keywordHTML += `<a href="https://neonataldisorders.com/recent-publications/index/${key_replace}" target="_blank" title="${key} - publication list">${key}</a>`; if (index < keywords.length - 1) { keywordHTML += ', '; } }); resultsContainer.innerHTML = keywordHTML; } // Call the function with the PHP data var recent_papers = [ { "title": "Prospective antimicrobial stewardship interventions by multidisciplinary teams to reduce neonatal antibiotic use in South Africa: the Neonatal Antimicrobial Stewardship (NeoAMS) study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38945432", "publishedDate": "2024" }, { "title": "Quality improvement initiative \\\\\\'S-A-F-H\\\\\\' to reduce healthcare-associated neonatal sepsis in a tertiary neonatal care unit.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38886106", "publishedDate": "2024" }, { "title": "Machine Learning: A Potential Therapeutic Tool to Facilitate Neonatal Therapeutic Decision Making.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38880837", "publishedDate": "2024" }, { "title": "Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38901777", "publishedDate": "2024" }, { "title": "Sepsis caused by Phytobacter diazotrophicus complicated with galactosemia type 1 in China: a case report.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38898413", "publishedDate": "2024" }, { "title": "Compliance with antibiotic therapy guidelines in french paediatric intensive care units: a multicentre observational study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38867164", "publishedDate": "2024" }, { "title": "Possible adverse events of imidazole antifungal drugs during treatment of vulvovaginal candidiasis: analysis of the FDA Adverse Event Reporting System.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38914572", "publishedDate": "2024" }, { "title": "Exploring factors influencing delayed first antibiotic treatment for suspected early-onset sepsis in preterm newborns: a study before quality improvement initiative.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38918783", "publishedDate": "2024" }, { "title": "Diagnostic significance of complete blood cell count and hemogram-derived markers for neonatal sepsis at Southwest Public Hospitals, Ethiopia.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38947992", "publishedDate": "2024" }, { "title": "Analysis of Differences in Neonatal Sepsis Caused by Streptococcus Agalactiae and Escherichia Coli.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38965964", "publishedDate": "2024" }, { "title": "Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38935376", "publishedDate": "2024" }, { "title": "Rare case of early neonatal sepsis caused by successfully treated with voriconazole.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/39108978", "publishedDate": "2024" }, { "title": "Acute Kidney Injury in Neonates: A Meta-Analysis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38872621", "publishedDate": "2024" }, { "title": "Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38873401", "publishedDate": "2024" }, { "title": "Late-Onset Sepsis among Extremely Preterm Infants of 24-28 Weeks Gestation: An International Comparison in 10 High-Income Countries.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38889700", "publishedDate": "2024" }, { "title": "Epidemiology and Outcomes of Neonatal Sepsis: Experience from a Tertiary Australian NICU.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38889701", "publishedDate": "2024" }, { "title": "A Retrospective Study Evaluating Neonatal Vancomycin Loading Doses to Achieve a Therapeutic Target.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38858809", "publishedDate": "2024" }, { "title": "Is the sFlt-1\/PlGF ratio efficient in predicting adverse neonatal outcomes in small-for-gestational-age newborns? A prospective observational multicenter cohort study.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38915764", "publishedDate": "2024" }, { "title": "Outcome of prelabor rupture of membranes before or at the limit of viability: systematic review and meta-analysis.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38648897", "publishedDate": "2024" }, { "title": "Gender and sex hormone effects on neonatal innate immune function.", "url": "https:\/\/pubmed.ncbi.nlm.nih.gov\/38839425", "publishedDate": "2024" } ]; var keywordsArray = ["Neonatal sepsis","fungi Septicaemia","C-Reactive Protein","leukocyte","bacterial infection","inflammatory disorders","antibiotic treatment","Serological Tests","Novel Treatment","microvascular thrombosi"]; displayResults_recent(recent_papers); displayKeywordPapers(keywordsArray); // function stripslashes(str) { // if (typeof str === 'string') { // return str.replace(/\/g, ''); // } // } </script></p> <h3><b>Immunomodulatory Therapies</b></h3> <p><span style="font-weight: 400;">Current knowledge in immunology has enabled researchers to draw up immunomodulatory procedures for the treatment of sepsis. These therapies seek to regulate the inflammation resulting from infection while at the same time boosting the immune system to fight infection. Some examples of anti-inflammatory treatment are cytokine inhibitors, interleukin 6 (IL-6) blockers, stimulators of immunity, and granulocyte-macrophage colony-stimulating factor (GM-CSF). There are still open trials that are conducting explorations concerning its safety and efficacy in treating sepsis in nursery infants. </span></p> <h3><b>Supportive Care</b></h3> <p><span style="font-weight: 400;">Thus, there is no doubt that supportive care continues to be an essential intervention in neonatal sepsis. These cover issues to do with oxygenation, ventilation, and fluid management. Pruning, mechanical ventilation, continuous positive airway pressure (CPAP), and extracorporeal membrane oxygenation (ECMO) can help maintain respiratory status in severe cases. The same can be said for perfect patient care, where such aspects as nutrition, temperature, and glycemic control, to name a few, are critical to achieving the best results. </span></p> <h3><b>Future Directions</b></h3> <p><span style="font-weight: 400;">Thus, the further effective diagnosis and management of neonatal sepsis will rely on innovative technologies and personalized medicine strategies. In the near future, omics technology like genomics and proteomics is likely to help in the discovery of new biomarkers and therapeutic targets. Implementation of new technologies in diagnostics includes polymerase chain reaction diagnostics, next-generation diagnostics, and other rapid diagnostics of pathogens. </span></p> <p><span style="font-weight: 400;">Additionally, the implementation of the generalized concept of organization and integration of personalized medicine, which considers the genetic and immunological characteristics of each neonate, will enable the use of treatment interventions that yield the best results. Precision medicine solutions, together with AI and machine learning approaches, will improve sepsis risk forecasting and the subsequent management of the situation. </span></p> <h3><b>Conclusion </b></h3> <p><span style="font-weight: 400;">There are improved approaches to the identification and management of this condition, making the outcomes of affected neonates improvable. Novel biomarkers like CRP, leukocyte indices, and PCT aid in sepsis diagnosis with the help of superior serological tests. The mechanisms of multimodal management employing the strategies of interdisciplinary cooperation in designing additional treatment paradigms and applying antimicrobial therapy, activated protein C, and immunomodulatory therapy provide additional horizons for enhancing neonatal sepsis care. As the research proceeds further, synthesized strategies based on individualized medication and the latest technologies will improve the basic treatment facilities for neonates with sepsis and, thus, restrict the morbidity and mortality rates of infected neonates.</span></p> <p></p> <h3><b>References</b></h3> <ol> <li>Lazzarotto, T., Guerra, B., Gabrielli, L., Lanari, M. and Landini, M.P., 2011. <a href="https://www.sciencedirect.com/science/article/pii/S1198743X14612064">Update on the prevention, diagnosis and management of cytomegalovirus infection during pregnancy.</a> <i>Clinical Microbiology and Infection</i>, <i>17</i>(9), pp.1285-1293.</li> <li>Stoll, B.J., Hansen, N.I., Bell, E.F., Shankaran, S., Laptook, A.R., Walsh, M.C., Hale, E.C., Newman, N.S., Schibler, K., Carlo, W.A. and Kennedy, K.A., 2010. <a href="https://publications.aap.org/pediatrics/article-abstract/126/3/443/66128/Neonatal-Outcomes-of-Extremely-Preterm-Infants">Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.</a> <i>Pediatrics</i>, <i>126</i>(3), pp.443-456.</li> <li>Picard, K.M., O’Donoghue, S.C., Young-Kershaw, D.A. and Russell, K.J., 2006. <a href="https://aacnjournals.org/ccnonline/article-abstract/26/3/43/975">Development and implementation of a multidisciplinary sepsis protocol.</a> <i>Critical Care Nurse</i>, <i>26</i>(3), pp.43-54.</li> <li>Carvalho, P.R. and Trotta, E.D.A., 2003. <a href="https://www.scielo.br/j/jped/a/MbdH53YTdSvqj3p53bNBggp/?lang=en">Advances in sepsis diagnosis and treatment.</a> <i>Jornal de Pediatria</i>, <i>79</i>, pp.S195-S204.</li> <li>Hengst, J.M., 2003. <a href="https://journals.lww.com/advancesinneonatalcare/abstract/2003/02000/The_Role_of_C_Reactive_Protein_in_the_Evaluation.3.aspx">The role of C-reactive protein in the evaluation and management of infants with suspected sepsis.</a> <i>Advances in neonatal care</i>, <i>3</i>(1), pp.3-13.</li> <li>Bochud, P.Y. and Calandra, T., 2003. <a href="https://www.bmj.com/content/326/7383/262.full">Pathogenesis of sepsis: new concepts and implications for future treatment.</a> <i>Bmj</i>, <i>326</i>(7383), pp.262-266.</li> <li>Hotchkiss, R.S. and Karl, I.E., 2003. <a href="https://www.nejm.org/doi/full/10.1056/nejmra021333">The pathophysiology and treatment of sepsis.</a> <i>New England journal of medicine</i>, <i>348</i>(2), pp.138-150.</li> </ol> <p></div></div> <div style="background: #f7f7f7;border: 1px solid rgba(0, 0, 0, 0.07);"> <div style="padding: 30px;"><div class="Adblock-main"> <div class="Adblock-head"> <h2>Top Experts on “<b style="color:#000;font-size:22px;">neonatal sepsis</b>“</h2> </div> </div><div class="author-main"><div id="results_author"></div><div style="text-align: center;"><a class="register-button" href="https://neonataldisorders.com/expert-search" target="_blank" rel="noopener">Find experts on any field</a></div></div><div class="inside-article" style="background: none;border: none;box-shadow: none;margin-top: -70px;"> <style> .author-block { padding: 15px; 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