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**Section 3** 

**Prevention and Treatment** 


**Prevention and Treatment** 

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**Chapter 6** 

© 2013 Resch and Resch, 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 Resch and Resch, 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.

**Immunoglobulins in the Prevention and** 

It is a daily challenge and the most common clinical practise to rule out possible bacterial infection in the ill neonate and especially in the preterm infant. Approximately half of all newborn infants admitted to the neonatal ward carry a diagnosis of "rule-out sepsis", and diagnosis is often difficult as symptoms and signs of bacterial infection are subtle and nonspecific (1). The incidence of infection is higher in the neonatal period than at any other time of life, and factors that determine this increased susceptibility to bacterial infection include on the one hand the immaturity of the immune system with poor humoral responses to organisms (IgG and A), relatively poor neutrophil responses and complement activity, impaired macrophage function, and relatively poor T cell function, and on the other hand the exposure to microorganism from the maternal genital tract by ascending infections via the amniotic fluid or transplacental haematogenous spread. Additionally peripartum factors like trauma to skin or vessels during parturition or exposure to invasive obstetric procedures as well as portals of colonization and subsequent invasion (umbilicus, mucosal surfaces, eye, skin especially in very preterm infants) contribute to this increased risk for bacterial infection (2). Among extremely low birth weight infants at least 65% had one or more infections during their hospitalization in a National Institute of Child Health and Human Development Neonatal Research Network study including 6093 infants with followup at 18 to 22 months of corrected gestational age. Compared with uninfected infants infected infants were significantly more likely to have adverse neurodevelopmental outcomes at follow-up, including cerebral palsy (range of significant odds ratios [ORs], 1.4- 1.7), low Bayley Scales of Infant Development II scores on the mental development index (ORs, 1.3-1.6) and psychomotor development index (ORs, 1.5-2.4), and vision impairment (ORs, 1.3-2.2). Infection in the neonatal period was also associated with impaired head growth, a known predictor of poor neurodevelopmental outcome (3). Reasons for the greater susceptibility to infection of preterm infants also include invasive procedures during

**Treatment of Neonatal Sepsis** 

Elisabeth Resch and Bernhard Resch

http://dx.doi.org/10.5772/54538

**1. Introduction** 

Additional information is available at the end of the chapter
