New Insights into Prevention, Diagnosis, and Treatment of Neonatal Sepsis and Short- and Long-Term Outcomes

Dear Colleagues,

Neonatal sepsis is an important cause of neonatal morbidity and mortality. The incidence is 1 to 5 cases per 1000 live births, and it is the third most common etiology of neonatal mortality. A serious, emerging, worldwide problem is antibiotic resistance, which has been declared a global threat to public health by the Centers for Disease Control and Prevention. Microorganisms normally develop resistance against antibiotics, especially after their widespread use, by expressing resistant genes that are normally suppressed.

• The definition of neonatal sepsis also creates challenges for effective antibiotic prescribing due to its reliance on microbiological criteria and the fact that it differs between adultand pediatric definitions. Many symptoms and clinical signs of neonatal sepsis arenon-specific and can be observed in other, more benign conditions. Because the definitionof neonatal sepsis is variable, the populations included in several clinical trials are also notwell defined, and the results of such studies can be questionable.Another difference between adults and neonates is that sepsis is diagnosed by apositive blood culture, and neonates rarely present with a focal infection. In adults, however,sepsis is usually the progression of a focal infection. Clinical criteria are often usedto diagnose neonatal sepsis rather than relying solely on blood culture results. Thesedifferences make it difficult to extrapolate research results from adult or pediatricpopulations to neonatal populations.
• Moreover, efforts are made to define indices of neonatal sepsis with both good sensitivity and specificity, but the optimal index or even an optimal combination of indices has not been fully elucidated. Molecular diagnosis is a new, promising field.
• Due to all these drawbacks in the diagnosis and treatment of neonatal sepsis, the prevention of this condition seems to play a crucial role. This attempt is not an easy task; hand hygiene and antibiotic stewardship are two basic strategies. Nevertheless, a bundle of preventive efforts is usually necessary to reduce the incidence of neonatal sepsis. A widely accepted standardized preventive bundle targeting multidrug-resistant organisms is lacking.
• We are pleased to invite you to contribute to this Special Issue, which is focused on new insights, innovations, drugs, and other new strategies for the definition, diagnosis, treatment, and prevention of neonatal sepsis, which continues to be a devastating condition with high mortality and morbidity and long-term consequences.

Prof. Vasilios Giapros
Dr. Dimitrios Rallis
Dr. Maria Baltogianni
Guest Editors

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• neonate
• sepsis
• early sepsis
• late sepsis
• antibiotic resistance
• multiple resistance antibiotics
• antibiotics stewardship