**Author details**

16 Neonatal Bacterial Infection

**Figure 7.** Therapeutic guidelines in neonatal infection 2011[11]

1. Neonatal sepsis requires the immediate diagnosis and treatment in neonates regardless

2. It is classified as early (<72hr) and late (>72hr); Late-late sepsis or Very Late Sepsis developing after 3 months of life in premature neonates with immune deficiencies. 3. Group B streptococcus (GBS) and staphylococcus are the most frequent agents of

4. Risk factors of neonatal sepsis include GBS bacteriuria at ongoing pregnancy (>104 cfu/mL), colonization of mothers by GBS, duration of anhydrous interval ≥18

6. Evaluation of neonates if sepsis is suspected, must include perinatal anamnesis, full physical examination and laboratory tests including CBA with leukogram, blood culture, lumbar puncture for the exception of meningitis before a/b therapy starts,

**12. Conclusions and recommendations** 

of gestational age or body weight at birth.

hours, mother's temperature at delivery ≥38º. 5. Non-specific and various clinical symptoms.

neonatal sepsis.

Ketevan Nemsadze *Georgian National Academy of Sciences, Georgia* 

### **13. References**


http://www.cdc.gov/groupbstrep/guidelines/new-differences.html (2010)

	- [11] *"Therapeutic guidelines in neonatal infection".2011*
	- [12] *J. Klein, S. Marcy. "Bacterial sepsis and meningitis". Mosby, 1995*
	- [13] William E. Benitz, MAdjunct." *Laboratory Tests in the Diagnosisof Early-OnsetNeonatal Sepsis";*2009

**Chapter 2** 

© 2013 Reiterer, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 Reiterer, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Neonatal pneumonia is a serious respiratory infectious disease caused by a variety of microorganisms, mainly bacteria, with the potential of high mortality and morbidity (1,2). Worldwide neonatal pneumonia is estimated to account for up to 10% of childhood mortality, with the highest case fatality rates reported in developing countries (3,4). It´s impact may be increased in the case of early onset, prematurity or an underlying pulmonary condition like RDS, meconium aspiration or CLD/bronchopulmonary dysplasia (BPD), when the pulmonary capacity is already limited. Ureaplasma pneumonia and ventilatorassociated pneumonia (VAP) have also been associated with the development of BPD and poor pulmonary outcome (5,6,7). In this chapter we will review different aspects of neonatal

pneumonia and will present case reports from our level III neonatal unit in Graz.

Reported frequencies of neonatal pneumonia range from 1 to 35 %, the most commonly quoted figures being 1 percent for term infants and 10 percent for preterm infants (8). The incidence varies according to gestational age, intubation status, diagnostic criteria or case definition, the level and standard of neonatal care, race and socioeconomic status. In a retrospective analysis of a cohort of almost 6000 neonates admitted to our NICU pneumonia was diagnosed in all gestational age classes. The incidence of bacterial pneumonia including Ureaplasma urealyticum (Uu) pneumonia was 1,4 % with a median patient gestational age of 35 weeks (range 23-42 weeks) and a mortality of 2,5%. There was only one case of viral pneumonia, due to RSV-infection and no case of fungal pneumonia. The mortality rate associated with pneumonia is in general inversely related to gestational age and birthweight, being higher in cases of early onset compared to late onset, and especially high in low socioecomomic groups and developing countries (2,3,4). Group B Streptococcus accounts for most cases of early onset pneumonia, the commonest bacteria causing late-

**Neonatal Pneumonia** 

Additional information is available at the end of the chapter

Friedrich Reiterer

**1. Introduction** 

**2. Epidemiology** 

http://dx.doi.org/10.5772/54310


http://pediatrics.aappublications.org/content/129/4/e1104.full.html

[16] Morven S Edwards, MD "Clinical features and diagnosis of sepsis in term and late preterm infants" updated: Dec 18, 2012 http://www.uptodate.com/contents/clinicalfeatures-and-diagnosis-of-sepsis-in-term
