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The changing spectrum of neonatal infectious disease
1Department of Pediatrics, University of Miami, Miller School of Medicine, Miami, FL 33136, USA. lplano@med.miami.edu
Insights
Neonatal infectious disease spectrum is shifting due to medical advances, increasing survival rates for premature infants. This change heightens the risk of infections from previously non-pathogenic organisms in vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Advances in neonatal care have led to increased survival rates for extremely premature infants.
- This success has altered the landscape of neonatal infectious diseases.
- Very low birth weight infants face heightened risks from a broader range of pathogens.
Purpose of the Study:
- To review the evolving patterns of neonatal infectious diseases.
- To highlight the changing role of microorganisms as pathogens in neonates.
- To emphasize the impact of medical practices and microbial adaptation on infection spectrum.
Main Methods:
- Literature review focusing on bacterial and fungal neonatal infections.
- Analysis of historical trends and current practices in neonatal care.
- Examination of pathogen evolution and adaptation under selective pressures.
Main Results:
- The spectrum of neonatal infections has significantly changed over time.
- Organisms previously considered benign are now recognized as common pathogens.
- Very low birth weight infants are particularly susceptible to these evolving threats.
Conclusions:
- Understanding the changing spectrum of neonatal infections is crucial for effective management.
- Therapeutic strategies must consider neonate maturity, age, and intensity of care.
- The review primarily addresses bacterial and fungal infections, with limited focus on viral agents.
Abstract:
To understand the changing spectrum of neonatal infectious disease, one must first be familiar with the history, the variety of organisms and the progression of change of neonatal infections over the years. As progressively more immature neonates are surviving, the spectrum of infectious disease has changed in response to current medical practice responsible for this success and to selective pressures on the microorganisms. The surviving very low birth weight infants are at a significant risk for contracting infections from this expanding repertoire of pathogens. Microorganisms once thought seemingly benign and nonpathogenic are now commonly accepted as pathogens and are among the most likely organisms to cause infections in this extremely vulnerable patient population. When considering the possible identity of infecting organisms and attempting to tailor specific therapies to decrease unwanted consequences, one must consider the level of maturity and the age of neonate, as well as the intensity of care necessary for a successful outcome. This brief review focuses primarily on the changing spectrum of bacterial and fungal infections and will not substantially address viral infections.
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