Related Experiment Video
Updated: Apr 17, 2026
A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
Published on: January 27, 2019
Late-onset sepsis in preterm infants: update on strategies for therapy and prevention
Mohan Pammi1, Leonard E Weisman
1Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 1102 Bates Street, FC 530.08, Houston, TX 77030, USA.
Insights
Late-onset sepsis affects many premature infants, leading to high mortality and long-term health issues. Prevention strategies like infection control and early feeding are key, while new therapies are under investigation.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatrics
Background:
- Late-onset sepsis affects 15-25% of very low birth weight neonates.
- Despite advances, mortality (18-36%) and morbidity (neurological, pulmonary) remain high.
- Current treatments include antibiotics and supportive care, with limited efficacy of adjunctive therapies.
Purpose of the Study:
- To review current understanding and management of late-onset sepsis in neonates.
- To evaluate the effectiveness of existing and emerging therapies.
- To identify beneficial preventive strategies.
Main Methods:
- Review of current literature on late-onset sepsis in neonates.
- Analysis of treatment outcomes and preventive measures.
- Assessment of data for adjunctive and novel preventive strategies.
Main Results:
- Preventive strategies like infection control, human milk feeds, and line care bundles are effective.
- Adjunctive therapies such as pentoxifylline have limited data, while others are ineffective.
- Promising preventive strategies include oral lactoferrin and monoclonal antibodies, requiring further evidence.
Conclusions:
- Effective prevention of late-onset sepsis relies on robust infection control and optimized neonatal care practices.
- Further research is needed to validate novel preventive strategies like oral lactoferrin and monoclonal antibodies.
- Early diagnosis and comprehensive management are crucial for improving outcomes in affected neonates.
Abstract:
Late-onset sepsis occurs in 15-25% of very low birth weight neonates. Early diagnosis and therapy optimize patient outcomes. Despite these efforts, mortality remains high (18-36%) and survivors suffer significant neurological and pulmonary morbidity. Although rapid diagnostics are improving, more are needed. Current therapy remains antibiotics and supportive care. Adjunctive therapies have either limited data (e.g., pentoxifylline) or have been found ineffective (e.g., granulocyte transfusions, granulocyte macrophage colony-stimulating factor/granulocyte colony-stimulating factor, and intravenous immunoglobulin). Preventive strategies that have proven beneficial include infection control measures (e.g., hand hygiene and universal precautions), early enteral feeds with human milk, early removal of central lines, catheter infection prevention bundles, antibiotic stewardship and focused quality improvement measures. Promising strategies to prevent late-onset sepsis include oral lactoferrin, and pathogen-specific monoclonal antibodies but more evidence is required to make practice recommendations.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....