NEONATAL SEPSIS: CHALLENGES IN DIAGNOSIS AND TREATMENT

Abstract

Neonatal sepsis (NS) is a clinical syndrome in which the patient shows systemic signs of infection, associated with the presence of bacteria, fungi or viruses in sterile fluids (blood or liquor) in the first month of life. NS is one of the main causes of neonatal death worldwide, and premature and low birth weight newborns (NB) are the most susceptible to developing it. A survey of articles published between 2011-2022 was carried out using PubMed, Scielo and Google Scholar. The search terms used were "Neonatal Sepsis" and "Neonatal Sepsis". Articles published in Portuguese or English were selected. As a result, it was found that neonatal sepsis is classified according to the time elapsed before the onset of signs and symptoms, being called early when it occurs in the first 72 hours of life and late when it occurs after these 72 hours. In this sense, the former is linked to the conditions of the delivery/mother and the NB at birth, while the latter is related to the use of medication, invasive procedures and hospitalization in Neonatal Intensive Care Units (NICUs). The clinical manifestations of this pathology are non-specific and are constantly confused with conditions of age/prematurity, consisting of difficulty breathing, tachycardia, lethargy, fever, jaundice with no other determining cause, vomiting, diarrhea and other alterations. Diagnosing NS is a challenge, since there is a lack of tools with optimum sensitivity for this, sometimes requiring several tests for confirmation. Even so, sometimes a diagnosis of clinical sepsis is made in order to immediately start antibiotic therapy, which is the basis of treatment for neonatal sepsis.