**7. Conclusion**

28 Neonatal Bacterial Infection

pneumonia on day 6 of life (Case 4)

**Figure 6.** Streaky-patchy lung changes with partly cystic appearance in Ureaplasma urealyticum

**Figure 7.** Early BPD changes in Ureaplasma urealyticum pneumonia on day 18 of life (Case 4)

Despite advances in neonatal medicine pneumonia remains a serious problem even in developed countries, mainly due to the increased survival of very preterm births and their susceptibility for early and late bacterial infections. The clinical spectrum of pneumonia is complex, symptoms are often non-specific and laboratory findings may be of limited value, making a rapid and correct diagnosis difficult. Treatment may also be challenging if no organism can be cultivated or in case of multidrug-resistant bacterial pneumonia. There is no clear evidence from randomized controlled trials favoring a specific antibiotic treatment strategy so that treatment decisions are based on local antimicrobial resistance patterns and clinical experience. Surfactant substitution might be beneficial in selected cases. Preventive strategies like health-care associated infection control and vaccination programs might have the greatest impact and should be further evaluated and applied at all levels of perinatal care.
