Neonatal sepsis can be the result of infections with bacterial, viral, or fungal (mostly yeast) microorganisms. The most common organisms associated with early-onset neonatal sepsis are Streptococcus agalactiae (GBS) and Escherichia coli The incidence of severe infections caused by multidrug-resistant (MDR) pathogens is currently rising worldwide, and increasing numbers of neonates and children with serious bloodstream infections due to resistant bacteria are being reported. Severe sepsis and septic shock due to gram-negative bacteria represent a significant cause of morbidity and mortality, and contribute to high health care costs. Antimicrobial resistance among Enterobacteriaceae represents a major problem in both health. OBJECTIVE: To study the bacterial pathogens causing neonatal sepsis and their sensitivity pattern so that guidelines can be prepared for empirical antibiotic therapy. MATERIALS AND METHODS: We conducted a prospective analysis of all the cases admitted to the neonatal intensive care unit (NICU) of a tertiary care hospital and studied the culture and sensitivity pattern of organisms isolated. The neonates who presented with signs and symptoms of septicemia, with/without pneumonia and/or. OBJECTIVE: To study the bacterial pathogens causing neonatal sepsis and their sensitivity pattern so that guidelines can be prepared for empirical antibiotic therapy. SETTING: The study was conducted in the neonatal intensive care unit (NICU) at PNS Shifa (Naval Hospital), Karachi during January 1997 to June 1999. METHODS: Blood specimens for culture were drawn from 520 newborns admitted in a NICU with sepsis. The specimens were inoculated into brain heart infusion broth. Subcultures were. .
Polymicrobial sepsis might also occur more often than currently estimated. As an additional diagnostic tool, PCR methods have the potential to increase diagnostic reliability of causal pathogens for neonatal sepsis. This could facilitate a reduction in unnecessary broad spectrum antibiotic usage, and target treatment to improve outcomes, as. A decreasing trend in prevalence of neonatal sepsis was found in recent years, although not statistically significant (c = -0.005; P value = 0.4). The most prevalent causative bacterial pathogens were Enterobacter spp. (23.04%), followed by Klebsiella pneumoniae (17.54%), coagulase-negative Staphylococci (14.06%), Escherichia coli (13.92%), Pseudomonas aeruginosa (12.67%), and Staphylococcus aureus (11.48%). CONCLUSION: Our findings showed a high prevalence of neonatal sepsis in. Also, Enterobacter spp. and Klebsiella pneumoniae were identified as the principal bacterial pathogens responsible for neonatal septicemia in Iran Among the bacterial pathogens causing the neonatal sepsis, our results indicated that the most prevalent causative pathogens belong to Enterobacter spp. (23.4%; 95%CI, 10.9-37.6%), followed by Klebsiella pneumoniae (17.5%; 95%CI, 9.7-26.8%), coagulase-negative Staphylococci (14.0%; 95%CI,8.9-19.9%), Escherichia coli (13.9%; 95%CI, 5.6-24.6%), Pseudomonas aeruginosa (12.6%; 95%CI, 5.3-22.1%), and Staphylococcus aureus (11.4%; 95%CI, 6.0-18.2%) Background: Neonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical antibiotics coverage
Diagnostic accuracy of the ROCHE Septifast PCR system for the rapid detection of blood pathogens in neonatal sepsis-A prospective clinical trial The Roche SeptiFast® MGRADE PCR using a modified DNA extraction protocol showed acceptable results for rapid detection of neonatal sepsis in addition to conventional blood culture Sepsis patients with resistant pathogens have been found to have a higher risk of hospital mortality. Group B streptococcus is the leading cause of both neonatal and maternal sepsis, though Escherichia coli is an emerging threat (8,9). Both of these pathogens have displayed considerable resistance to treatment and are considered priority pathogens for research and development (R&D) of new. Neonatal infections are infections of the neonate (newborn) acquired during prenatal development or in the first four weeks of life (neonatal period). Neonatal infections may be contracted by mother to child transmission, in the birth canal during childbirth, or contracted after birth Keywords: Neonatal sepsis, Pathogen, Drug resistance Background Neonatal sepsis (NS) is an inflammation-induced systemic inflammatory response syndrome and an im-portant cause of neonatal deaths [1, 2]; this condition comprises systemic poisoning symptoms caused by a large number of toxins produced by bacteria upon entr
- Neonatal sepsis differential diagnosis - Normal CSF indices in neonates - Antibiotic regimens for neonatal sepsis - Bacterial pathogens in neonates - Antimicrobial therapy for neonatal GBS infection RELATED TOPICS. Approach to the ill-appearing infant (younger than 90 days of age) Bacterial meningitis in the neonate: Clinical features and diagnosi . This study will provide a data on the bacterial pathogens causing neonatal sepsis along with their antibiogram. To study the spectrum of significan
Key Words: neonatal infections, etiology, pathogens, community, developing country (Pediatr Infect Dis J 2009;28: S10-S18) N eonatal sepsis is classiﬁed as early onset if it occurs within the ﬁrst week of life and as late onset if occurring after the ﬁrst week until the end of the neonatal period.1 Early onset sepsis is conventionally regarded as maternally-acquired, with. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study Investigators of the Delhi Neonatal Infection Study (DeNIS) collaboration* Summary Background Sepsis is one of the most common causes of neonatal deaths globally. Most sepsis-related deaths occur in low-income and middle-income countries, where the. Neonatal sepsis (NS) kills 750,000 infants every year. Effectively treating NS requires timely diagnosis and antimicrobial therapy matched to the causative pathogens, but most blood cultures for suspected NS do not recover a causative pathogen. We refer to these suspected but unidentified pathogens as microbial dark matter. Given these low culture recovery rates, many non-culture-based.
South African studies determined K. pneumoniae and S. aureus are leading pathogens of neonatal sepsis [11, 12]. However, in this study, S. aureus was not a common cause of sepsis. Among Enterobacterales, K. pneumoniae was isolated most frequently, alongside other organisms such as E. coli. Studies confirm that E. coli and K. pneumoniae are well-recognized pathogens of neonatal sepsis [8, 9, 27. Neonatal sepsis is still one of the leading causes of neonatal mortality; yet, confirming the clinical suspicion of neonatal sepsis remains challenging [1, 2]. Up to 20% of very low birth weight infants (VLBWI) may acquire at least one episode of culture-positive sepsis during the hospital stay [ 3 ], with an incidence of up to 50% for clinical sepsis without microbiological confirmation [ 3. Pseudomonas are the leading pathogens in neonatal sepsis and the most commonly used antibiotics using in our setup are highly resistant with them which may be used when culture reports are awaiting. REFERENCE septicemia isolates and resistance patterns in a te 1. Ann L Anderson-Berry, MD, Neonatal sepsis emedicin and social factors associated with neonatal sepsis (11, 30, 31). PATHOGENS The organisms most frequently involved in early-onset neonatal sepsis of term and preterm infants together are GBS and Esche-richia coli, which account for approximately 70% of infections combined. Additional pathogens to consider, which account fo Microbial pathogens causative of neonatal sepsis in Arabic countries. J Matern Fetal Neonatal Med 2011; 24(8):990-4. Pierrakos C, Vincent JL. Sepsis biomarkers: a review. Critical Care 2010; 14(1):R15. Naher B, Mannan M, Noor K, Shahidullah MJ. Role of serum procalcitonin and C-reactive protein in the diagnosis of neonatal sepsis. Bangladesh Med Res Counc Bull 2011; 37(2):40-6. Sadiq ZM.
PCR for the detection of pathogens in neonatal early onset sepsis 1. Vergnano S, Menson E, Kennea N, Embleton N, Russell AB, Watts T, et al. Neonatal infections in England: the NeonIN... 2. Stocker M, Fontana M, El Helou S, Wegscheider K, Berger TM. Use of procalcitonin-guided decision-making to. thetype of sepsis were shown in Table and Figure .Gram-positive bacteria were responsible for most cases of neonatal sepsis. Coagulase negative staphylococci (CoNS) were the most frequent isolated pathogens in EoNS and LoNS, fol-lowed by Klebsiella pneumoniae and Serratiamarcescens . 0 10 20 30 40 50 60 70 80 90 100 AMP AMC CAZ FOX AK CN CIP NOR IPM OX V Group B streptococcus is the leading cause of both neonatal and maternal sepsis, though Escherichia coli is an emerging threat (8,9). Both of these pathogens have displayed considerable resistance to treatment and are considered priority pathogens for research and development (R&D) of new antibiotics
understanding of epidemiology of sepsis in neonates in low-income and middle-income countries. We report a high burden of sepsis among neonates born in tertiary hospitals. Almost two-thirds of sepsis episodes occurred at or before 72 h of life and were caused by pathogens usually associated with nosocomial infections Neonatal sepsis is ranked as the third highest cause of neonatal demise globally, in which AMR accounted for 31.0% of deaths. AMR in neonates has been poorly characterised in Durban, South Africa. Thus, the resultant effect of AMR on empiric regimens for neonatal sepsis is uncertain in this setting Sepsis is an important cause of morbidity and mortality among newborn infants. Although the incidence of sepsis in term and late preterm infants is low, the potential for serious adverse outcomes, including death, is of such great consequence that caregivers should have a low threshold for evaluation and treatment for possible sepsis in neonates Neonatal sepsis (NS) kills 750,000 infants every year. Effectively treating NS requires timely diagnosis and antimicrobial therapy matched to the causative pathogens, but most blood cultures for suspected NS do not recover a causative pathogen. We refer to these suspected but unidentified pathogens as microbial dark matter. Given these low culture recovery rates, many non-culture-based technologies are being explored to diagnose NS, including PCR, 16S amplicon sequencing, and whole. Of 51 (24.1%) episodes diagnosed as culture proven sepsis, the same pathogen was detected by blood culture and PCR in 39 episodes (76.5%). In 8 episodes, more pathogens were detected by PCR compared to blood culture, and in 4 episodes the pathogen detected by blood culture was not found by PCR
Neonatal late-onset sepsis (LOS) is a serious problem in neonatal intensive care. Coagulase-negative staphylococci, especially Staphylococcus epidermidis , have emerged as the predominant pathogen of LOS in very low birth weight (VLBW) infants, accounting for up to 77.9% of neonatal LOS in industrialized countries and 46.5% in some developing regions Isolation of a recognised pathogen from blood, cerebrospinal fluid, or other body fluids in neonates suspected to have sepsis on the basis of clinical features or maternal or perinatal risk factors, along with treatment involving appropriate type and duration of antibiotic therapy
Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by setting. Differing estimates of disease burden have been reported from high-income countries compared with reports from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection, acquisition from maternal. Major causative pathogens of neonatal late-onset sepsis and their incidence by geographical areas. Gram-negative bacilli responsible for neonatal LOS mainly include Escherichia coli, Klebsiella spp., Enterobacter spp. and Pseudomonas spp. (figure 1) Microbiology of Neonatal Sepsis Longitudinal trends in the demographics, pathogens, and outcome were observed in a single-center database on neonatal sepsis at Yale-New Haven Hospital from 1928.2 Streptococcus pneumoniae and group A streptococci were the major causes of neonatal sepsis from 1933 to 1943. From the late 1940s to th
Neonatal sepsis, or illness caused by systemic bacterial infection, is a major cause of paediatric morbidity and mortality. The 2015 Global Burden of Disease study identified neonatal sepsis as the third most common cause of newborn ### What you need to know A 10 day old, full term baby is referred to the emergency department by his paediatrician for tachypnoea and decreased breastfeeding. Most sepsis-related deaths occur in low-income and middle-income countries, where the epidemiology of neonatal sepsis remains poorly understood. Most of these countries lack proper surveillance networks, hampering accurate assessment of the burden of sepsis, implementation of preventive measures, and investment in research. We report results of neonates born in hospital from a multicentre. Describe at least 3 common pathogens in the NICU 6. Discuss diagnostic tests used in diagnosis of sepsis 7. Describe nursing interventions for a septic infant Introduction There have been many advances in prevention, assessment and treatment of neonatal sepsis in the past few decades. However, the morbidity and mortality associated with sepsis remains high for susceptible neonates. Discussion.
Late-onset neonatal sepsis is sepsis occurring after 72 hour in neonatal intensive care unit infants and 7 days of life in term infants, has been variably defined as occurring up to the age of <90 or 120 days, and may be caused by vertically or horizontally acquired pathogens 12) The total mortality rate for the proven neonatal sepsis was 51% (25/49) and 42.9% (39/91) for EOS and LOS, respectively. Coagulase negative staphylococci were predominant isolates in both EOS and LOS, followed by Klebsiella pneumoniae. Most of the bacterial isolates had low sensitivity to the commonly used empiric antibiotics. However, 70.1% (89/127) exhibited multidrug resistance. Best sensitivities among Gram-positive isolates were found against imipenem, ciprofloxacin, vancomycin, and. Sepsis is a major cause of morbidity and mortality among neonates and infants. Antibiotics are a central part of the first line treatment for sepsis in neonatal intensive care units worldwide. However, the evidence on the clinical effects of the commonly used antibiotic regimens for sepsis in neonates remains scarce. This systematic review aims to assess the efficacy and harms of antibiotic.
of neonatal sepsis pathogens Fully automated multiplex detection Hahn-Schickard developed an integrated and fully automated LabDisk for rapid and highly sensitive molecular dia-gnostic-based detection of bacterial pathogens asso-ciated with neonatal sepsis. Neonatal sepsis is a major cause of infant death worldwide. Conventional diagnosis on th Neonatal sepsis (NS) is one of the leading causes of morbidity and mortality in infants worldwide. 1 It is classically divided into early-onset sepsis (within the first 72 h of life, EOS) and late-onset sepsis (3-28 days after birth, LOS), depending on the age at the onset of the sepsis episode. Neonatal sepsis can result from infections by bacteria, viruses, or fungi. Early-onset sepsis is. Neonatal sepsis is a diagnosis made in infants less than 28 days of life and consists of a clinical syndrome that may include systemic signs of infection, circulatory shock, and multisystem organ failure. Commonly involved bacteria include Staphylococcus aureus and Escherichia coli. Risk factors include central venous catheter use and prolonged hospitalization Conclusion The isolation rate of bacterial pathogens in neonatal sepsis was considerably high. In addition, nearly 70% of isolates were MDR strains. Low birth weight, low Apgar score, preterm.
cause for neonatal sepsis is identified in only one-fifth of cases, the list of possibly causative pathogens is not only long but also varies between populations (-79). This poses considerable difficulty in providing protection from neonatal sepsis through pathogen-specific vaccination. A pathogen-agnostic approach to broadly protect from neonatal sepsis is urgently needed. Neonatal bacille. Early-onset neonatal sepis pathogens were 58% (7/12) susceptible to gentamicin and 52% (11/21) susceptible to ampicillin, the institution's current empirical treatment regimen for early onset neonatal sepsis. The susceptibility of early-onset neonatal sepis pathogens to other antibiotics was as follows: penicillin 75% (6/8), amoxicillin clavulanate 67% (8/12), vancomycin 100% (13/13. Neonatal meningitis is caused by group B streptococci Streptococcus agalactiae (39%-48% of cases), Escherichia coli (30%-35%), other Gram-negative rods (8%-12%), Streptococcus pneumoniae (about 6%), and Listeria monocytogenes (5%-7%) attention to the burden of neonatal sepsis, the pathogen profile, and the extent of antimicrobial resistance in South Asia, and propose priority actions for policymakers and health professionals in the region. Paucity of high quality data We found no data on neonatal sepsis from Afghanistan, Bhutan, Maldives, and little from Sri Lanka. While the neonatal health indicators of three of these. Pathogens can enter through the prenatal, perinatal, and postnatal periods . Genetic Predisposition to SepsisMultiple factors play into a neonate's response to infection and the possible development of sepsis. One of these factors is genetics. As science has moved into recognizing the human genome there have also been advances with finding genetic contributions to sepsis.The body's first.
Furthermore, the pathogens associated with neonatal sepsis include viruses and parasites, in addition to bacteria . 2) The authors mention the total number of culture (blood, urine and cerebrospinal fluid (CSF)) samples and their positivity rates, but not the total number of newborns being assessed (sample size). Therefore, the percentage of newborns who ultimately have culture (blood, urine. Late-onset neonatal sepsis is usually acquired from the environment (see Neonatal Hospital-Acquired Infection). Staphylococci account for 30 to 60% of late-onset cases and are most frequently due to intravascular devices (particularly central vascular catheters). E. coli is also becoming increasingly recognized as a significant cause of late-onset sepsis, especially in extremely LBW infants treatment of neonatal sepsis. Resistant pathogens have been found all over the world in urban and . rural areas in both high- and low-income countries and the number of . antibiotics that no longer work for many of these pathogens is growing. This is reflected in the survey, where 79% of physicians report seeing an increasing trend of multidrug resistant infections over the last 5 years. In. Neonatal sepsis caused byE. coli, Staph-ylococcus species, and other pathogens was diag-nosed similarly. Infants with sepsis diagnosed by clinical signs and leukocyte count without confir-mation.
Neonatal meningitis in developing countries is a serious problem, with a mortality of 33-48%. 6 The pathogens involved are similar to those associated with sepsis, mainly Gram negative organisms such as Klebsiella, E coli, Serratia marscesens, Pseudomonas, and Salmonella, and among the Gram positive organisms Staph aureus and CONS. A multicentre WHO study on serious infections in young. Gram-negative organisms were the predominant pathogens in Libya, Egypt, Jordan, and Iraq (65-90% of all sepsis cases) with Klebsiella species (spp.), Serratia spp., Enterobacter spp., Escherichia coli, and Pseudomonas spp. being the most frequent bacteria
Neonatal sepsis and specific pathogens are discussed separately. (See Clinical features, evaluation, and diagnosis of sepsis in term and late preterm infants and Management and outcome of sepsis in term and late preterm infants.) PATHOGENESIS. Neonatal pneumonia can have early or late onset. Bacteria are the principal pathogens for both types In the United States, the most common pathogens responsible for early-onset neonatal sepsis are GBS and Escherichia coli. 17 A combination of ampicillin and an aminoglycoside (usually gentamicin) is generally used as initial therapy, and this combination of antimicrobial agents also has synergistic activity against GBS and Listeria monocytogenes. 82, 83 Third-generation cephalosporins (eg. Neonatal sepsis is invasive infection, usually bacterial, occurring during the neonatal period. Signs are multiple, nonspecific, and include diminished spontaneous activity, less vigorous sucking, apnea, bradycardia, temperature instability, respiratory distress, vomiting, diarrhea, abdominal distention, jitteriness, seizures, and jaundice Sepsis is one of the most common causes of neonatal mortality, especially in developing countries. The purpose of this study was to systematically review the bacterial causative agents of neonatal sepsis and their antibiotic susceptibility in Iran.We searched all previously published papers to gather related information on Iranian neonatal sepsis in international and national databases (in. The neonatal gut harbors sepsis-causing pathogens, but such organisms are not inevitable members of the normal microbiota. Surveillance microbiology, decolonization, and augmented hygiene might prevent dissemination of invasive bacteria between and within premature infants
In the neonatal period, pneumococcal sepsis may have an early or late onset. The transmission of the germ in these cases is not clear, and 2 possible forms are described: vertical by vaginal colonization of pneumococcus, and horizontal due to local infections or infections by non-vaccine serogroups Neonatal sepsis, sepsis neonatorum, and neonatal septicemia are terms that have been used to describe the systemic response to infection in newborn infants. There is little agreement on the proper use of the terms, i.e., whether their use should be restricted to bacterial infections, positive blood cultures, or severity of illness . In 1991, the American College of Chest Physicians and the.
20. Fungal pathogens are rarely associated with early-onset neonatal sepsis, and Candida spp. are most likely, occurring primarily among VLBW infants. Candida infections may also present as congenital candidiasis that can occur in term or preterm infants, with symptoms occurring at birth or within the first 24 h of life 21. 2 Saving newborns with neonatal sepsis. European researchers developed a sample-to-result automated system for detecting blood pathogens in infants at the point of care One thousand two hundred blood cultures of neonates were evaluated during the study period. Out of 1200 clinically suspected cases of neonatal sepsis, 1024 (84.33%) were early-onset and 176 (14.67%) were late- onset in which positive blood culture was found in 290 (28.32%) and 73 (41.47%) cases respectively. Neonates ages ranging from 1 to 28 days with a mean age of 2.69±4.39 days. The mode was equal to 1 day and median equal to 1day. Among 1200 enrolled neonates 843(70.25%) were. Neonatal sepsis is defined as a clinical syndrome in an infant 28 days of life or younger, manifested by systemic signs of infection and isolation of a bacterial pathogen from the bloodstream . Diagnosis and management of sepsis are a great challenge facing neonatologists in NICUs. Clinical diagnosis of presentation is difficult due to nonspecific signs and symptoms. In addition, laboratory.
Neonatal infection and sepsis Etiology. Early-onset infection/ sepsis. ≤ 6 days after delivery  Common causes: chorioamn ionitis, bac terial colonization of the maternal genital tract (pathogen transfer to the infant cause for neonatal sepsis is identified in only one-fifth of cases, the list of possibly causative pathogens is not only long but also varies between populations (-79). This poses considerable difficulty in providing protection from neonatal sepsis through pathogen-specific vaccination. A pathogen-agnostic approach to broadly protect fro As part of this initiative, the GARDP has launched a neonatal sepsis programme, which will include the NeoAMR Project (to be launched on Nov 8, 2017). This project will aim to develop new, globally applicable, empirical antibiotic regimens and strategies for the treatment of neonatal sepsis that can be adapted to settings with varying prevalence of multidrug-resistant pathogens
The pathogens causing neonatal sepsis include gram-positive and gram-negative bacteria . The mortality and the distribution pattern of pathogens causing sepsis in neonates differs between low- and middle-income countries and high-income countries. Important patho-gen variations can sometimes even be seen between in- dividual neonatal intensive care units (NICUs) within a given country. Neonatal sepsis refers to an infection involving bloodstream in newborn infants less than 28 days old. It continues to remain a leading cause of morbidity and mortality among infants, especially in middle and lower-income countries. It is divided into early-onset sepsis (EOS) or late-onset sepsis (LOS) based on the age of presentation after birth with different experts using 72 hours or 7 days.
neonatal sepsis is generally acquired from pathogens of maternal genital tract, whereas late onset sepsis (after first week till 28 days of life) has its environmental origin either in the community or in hospital.2 Neonatal sepsis or sepsis neonatorum has considerable contribution in the high neonatal morbidity and mortality. World over, nearly 1.6 million neonatal deaths are caused by. 1 Sepsis in the Newborn Sepsis is the commonest cause of neonatal mortality; it is responsible for about 30-50% of the total neonatal deaths in developing countries.1,2 It is estimated that up to 20% of neonates develop sepsis and approximately 1% die of sepsis related causes.2 Sepsis related mortality is largely preventable with prevention of sepsis itself, timely recognition, rational. Neonatal sepsis, a systemic infection in the first 28 days of life, encompasses bloodstream infections, meningitis, and pneumonia. It is the third most common cause of deaths among neonates, accounting for 225 000 deaths globally every year.1 South Asia and sub-Saharan Africa have the highest burden of neonatal sepsis in the world neonatal sepsis may no longer be effective in treating many new-borns with sepsis.3 This review summarizes available data on antimicrobial re-sistance among common pathogens causing infections in neonates and young infants seen in community settings in developing coun-tries-namely Klebsiella species, E. coli, and S. aureus. METHODS To identify studies documenting antimicrobial resistance in. Sepsis is defined as symptoms and signs of systemic infection caused by a pathogen in the blood. Meningitis is defined as inflamed meninges typically caused by a pathogen in the central nervous system. Because neonates have an immature immune system, they are at increased risk for sepsis and meningitis caused by bacterial pathogens
The primary pathogens causing early-onset neonatal sepsis in the United States are group B streptococcus (GBS) and Escherichia coli (E. coli). Over the past 30 years, the implementation of universal maternal screening for GBS with intrapartum antibiotic prophylaxis has reduced the incidence of early onset neonatal GBS sepsis from 1.5 to 0.3/1,000 live births. (Oh, 2013) There is significant. OBJECTIVE We sought to examine pathogen distribution and clinical presentation of late-onset sepsis (LOS) at an urban tertiary care center. STUDY DESIGN We performed a retrospective review of all culture-confirmed cases of LOS presenting to our institution from 2013 to 2017. Medical records were evaluated for demographic information, sepsis risk factors, encounter location, and clinical outcome Refinements to allow early, accurate, and cost-effective identification of pathogens responsible for neonatal sepsis would be anticipated in the next 5 years. Acknowledgments. Potential conflicts of interest. Author: No reported conflicts. Author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. References. 1. Liu. L , Johnson. HL, Cousens. S, et al. Global.