Challenges in developing a consensus definition of neonatal sepsis

Area of Science:

• Neonatology
• Infectious Diseases
• Critical Care Medicine

Background:

• Neonatal sepsis is a major cause of death and illness in newborns.
• Current sepsis definitions are inadequate for neonates, especially premature infants.
• Existing criteria vary widely and often overemphasize microbiological cultures.

Purpose of the Study:

• To highlight the urgent need for a unified definition of neonatal sepsis.
• To discuss challenges in defining and screening for neonatal sepsis.
• To propose a roadmap for developing consensus criteria using the Sepsis-3 framework.

Main Methods:

• Review of existing neonatal sepsis definitions and criteria.
• Analysis of the Sepsis-3 guidelines for adult sepsis.
• Discussion of common themes and shortcomings in current neonatal sepsis definitions.

Main Results:

• There is no consensus definition for neonatal sepsis.
• Existing definitions are not suitable for the neonatal intensive care unit (NICU) or premature infants.
• Organ dysfunction is underutilized as a diagnostic criterion in neonates.

Conclusions:

• A consensus definition and validated screening criteria for neonatal sepsis are essential.
• Developing these criteria will be challenging due to unique neonatal presentations.
• Such consensus will benefit clinical management, health service design, and research.