Modern approaches to diagnosis and treatment of early-onset neonatal sepsis


  • Tetiana Klymenko Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176, Ukraine
  • Olha Tsodikova Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176, Ukraine
  • Elena Serdceva Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176, Ukraine



newborns, neonatal sepsis, early-onset neonatal sepsis, diagnosis, antibacterial therapy


Early-onset neonatal sepsis (EOS) remains the leading cause of morbidity and mortality, especially among premature babies. Therefore, accurate diagnosis, prompt monitoring of the course of the disease and an effective therapeutic strategy are a guarantee of improving the quality of medical care for newborns, as well as an important reserve for reducing perinatal losses.

The aim of the work to summarize modern views on the diagnosis and treatment of early-onset neonatal sepsis in newborns with perinatal pathology.

Results and their discussion. An analytical review of modern literature data on problematic issues of EOS diagnostics is carried out. The approaches are stated and the main directions of EOS management at the present stage are formulated. It was revealed that the lack of a consensus definition of neonatal sepsis, the nonspecificity of clinical data is a limiting factor in the timely accurate identification of the septic process. Insufficient diagnostic value of existing laboratory tests leads to defects in the registry and monitoring of this disease, the inability to conduct an objective assessment of the existing epidemiological and microbiological situation in the health care system and the subsequent effective implementation of preventive measures.

Conclusions. In the conditions of modern scientific realities, none of the existing laboratory tests can sufficiently reliably confirm or deny the presence of EOS in a newborn child, which determines the search for new promising laboratory tests with high diagnostic and prognostic potential. The optimal treatment strategy for newborns with EOS is broad-spectrum antibiotics. However, today the global problem of excessive irrational prescribing of antibacterial drugs is associated with the formation of multidrug-resistant strains of bacteria, as well as the development of long-term adverse effects, which requires improved diagnostic and treatment algorithms for children who are in the risk group of the development of neonatal sepsis by implementing a comprehensive approach using modern accurate tests in the dynamics of the disease

Author Biographies

Tetiana Klymenko, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Neonatology

Olha Tsodikova, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

MD, Professor, Head of Department

Department of Outpatient Pediatrics

Elena Serdceva, Kharkiv Medical Academy of Postgraduate Education Amosova str., 58, Kharkiv, Ukraine, 61176

PhD, Associate Professor

Department of Sciences in Medicine, Neonatology


  1. Benitz, W. E., Achten, N. B. (2020). Finding a role for the neonatal early-onset sepsis risk calculator. EClinicalMedicine, 19, 100255. doi:
  2. Puopolo, K. M. (2019). Neonatal sepsis evaluation across the pond. Archives of Disease in Childhood – Fetal and Neonatal Edition, 105 (2), 116–117. doi:
  3. Puopolo, K. M., Benitz, W. E., Zaoutis, T. E. (2018). Management of Neonates Born at ≤34 6/7 Weeks’ Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics, 142 (6), e20182896. doi:
  4. Wattal, C., Kler, N., Oberoi, J. K., Fursule, A., Kumar, A., Thakur, A. (2019). Neonatal Sepsis: Mortality and Morbidity in Neonatal Sepsis due to Multidrug-Resistant (MDR) Organisms: Part 1. The Indian Journal of Pediatrics, 87 (2), 117–121. doi:
  5. Giannoni, E., Agyeman, P. K. A., Stocker, M., Posfay-Barbe, K. M., Heininger, U., Spycher, B. D. et. al. (2018). Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study. The Journal of Pediatrics, 201, 106–114.e4. doi:
  6. Schrag, S. J., Farley, M. M., Petit, S., Reingold, A., Weston, E. J., Pondo, T. et. al. (2016). Epidemiology of Invasive Early-Onset Neonatal Sepsis, 2005 to 2014. Pediatrics, 138 (6), e20162013. doi:
  7. Heorhiiants, M. A., Zhovnir, V. A., Korsunov, V. A., Dmytriiev, D. V., Posternak, H. I., Snisar, V. I., Shchurovska, I. P. (2017). Unified clinical protocol of emergency, primary, secondary (specialized) and tertiary (highly specialized) medical care and intensive care Septic shock in children (project) (part 2). Pain, Anesthesia and Intensive Care, 4 (81), 11–26. doi:
  8. Wagstaff, J. S., Durrant, R. J., Newman, M. G., Eason, R., Ward, R. M., Sherwin, C. M. T., Enioutina, E. Y. (2019). Antibiotic Treatment of Suspected and Confirmed Neonatal Sepsis Within 28 Days of Birth: A Retrospective Analysis. Frontiers in Pharmacology, 10. doi:
  9. Zea-Vera, A., Ochoa, T. J. (2015). Challenges in the diagnosis and management of neonatal sepsis. Journal of Tropical Pediatrics, 61 (1), 1–13. doi:
  10. Nikonov, V. V., Sokolov, A. S., Feskov, A. E. (2017). Sepsis from antiquity to contemporaneity. A view through the centuries. Emergency Medicine, 3 (82), 73–81. doi:
  11. Reinhart, K., Bauer, M., Riedemann, N. C., Hartog, C. S. (2012). New Approaches to Sepsis: Molecular Diagnostics and Biomarkers. Clinical Microbiology Reviews, 25 (4), 609–634. doi:
  12. Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M. et. al. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315 (8), 801–810. doi:
  13. Wynn, J. L. (2016). Defining neonatal sepsis. Current Opinion in Pediatrics, 28 (2), 135–140. doi:
  14. Polin, R. A. (2012). Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics, 129 (5), 1006–1015. doi:
  15. Johansson Gudjónsdóttir, M., Elfvin, A., Hentz, E., Adlerberth, I., Tessin, I., Trollfors, B. (2019). Changes in incidence and etiology of early-onset neonatal infections 1997–2017 – a retrospective cohort study in western Sweden. BMC Pediatrics, 19 (1). doi:
  16. Shehab El-Din, E. M. R., El-Sokkary, M. M. A., Bassiouny, M. R., Hassan, R. (2015). Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt. BioMed Research International, 2015, 1–11. doi:
  17. Shah, B. A., Padbury, J. F. (2014). Neonatal sepsis: an old problem with new insights. Virulence, 5 (1), 170–178. doi:
  18. Neonatal infection (early onset): antibiotics for prevention and treatment (2012). Clinical guideline. Available at:
  19. Wynn, J. L., Wong, H. R., Shanley, T. P., Bizzarro, M. J., Saiman, L., Polin, R. A. (2014). Time for a Neonatal-Specific Consensus Definition for Sepsis. Pediatric Critical Care Medicine, 15 (6), 523–528. doi:
  20. Klingenberg, C., Kornelisse, R. F., Buonocore, G., Maier, R. F., Stocker, M. (2018). Culture-Negative Early-Onset Neonatal Sepsis – At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship. Frontiers in Pediatrics, 6. doi:
  21. Kostiuk, O. O., Shunko, Ye. Ye., Krasnova, Yu.Yu. (2014). Rannii neonatalnyi sepsys. Osnovni napriamky diahnostyky ta likuvannia. Neonatolohiia, khirurhiia ta perynatalna medytsyna, 4 (3 (13)), 104–109.
  22. Dritsakou, K., Liosis, G., Gioni, M., Glynou, E., Avdeliodi, K., Papagaroufalis, K. (2014). CRP levels in extremely low birth weight (ELBW) septic infants. The Journal of Maternal-Fetal & Neonatal Medicine, 28 (2), 237–239. doi:
  23. Hofer, N., Jank, K., Strenger, V., Pansy, J., Resch, B. (2015). Inflammatory indices in meconium aspiration syndrome. Pediatric Pulmonology, 51 (6), 601–606. doi:
  24. Muniraman, H., Gardner, D., Skinner, J., Paweletz, A., Vayalakkad, A., Chee, Y. H. et. al. (2017). Biomarkers of hepatic injury and function in neonatal hypoxic ischemic encephalopathy and with therapeutic hypothermia. European Journal of Pediatrics, 176 (10), 1295–1303. doi:
  25. Lee, J., Bang, Y. H., Lee, E. H., Choi, B. M., Hong, Y. S. (2017). The influencing factors on procalcitonin values in newborns with noninfectious conditions during the first week of life. Korean Journal of Pediatrics, 60 (1), 10–16. doi:
  26. Bellos, I., Fitrou, G., Daskalakis, G., Thomakos, N., Papantoniou, N., Pergialiotis, V. (2018). Soluble TREM-1 as a predictive factor of neonatal sepsis: a meta-analysis. Inflammation Research, 67 (7), 571–578. doi:
  27. Parri, N., Trippella, G., Lisi, C., De Martino, M., Galli, L., Chiappini, E. (2019). Accuracy of presepsin in neonatal sepsis: systematic review and meta-analysis. Expert Review of Anti-Infective Therapy, 17 (4), 223–232. doi:
  28. Shunko, Ye. Ye. (Ed.) (2014). Neonatolohiia: natsionalnyi pidruchnyk. Vol. 1. Kyiv, 960.




How to Cite

Klymenko, T., Tsodikova, O., & Serdceva, E. (2020). Modern approaches to diagnosis and treatment of early-onset neonatal sepsis. ScienceRise: Medical Science, (4 (37), 49–52.



Medical Science