State of the science: neonatal bacterial infection in the early 21st century.

Bacterial infections continue to cause significant neonatal morbidity and mortality, especially in small preterm neonates in the neonatal intensive care unit. Maternal and newborn risk factors can be used to prevent newborn infection and initiate early clinical assessments, laboratory diagnostic tests, and antimicrobial agent therapies. Early-onset and late-onset infections have different clinical patterns; however, each must be recognized as soon as possible in order to optimize outcomes. Antibiotics have long been the mainstay of treatment but organism resistance and weak immune system functioning of very premature newborns makes treatment challenging. Research continues on other markers for infection that may lead to more rapid diagnosis. The discovery of new therapies to improve newborn immune system function promises further improvement in outcomes of newborn infection. This article gives an overview of the state of diagnosis and treatment of newborn infection.