Volume 3- Issue 3: 2018 3309 Neonatal Sepsis Past to Present Santosh Kumar Kamalakannan* Assistant professor of Neonatology, Saveetha medical college, India Received: March 09, 2018; Published: April 04, 2018 *Corresponding author: Santosh Kumar Kamalakannan, Assistant professor of Neonatology Saveetha medical college, India, Tel: ; Email: ISSN: 2574-1241 DOI: 10.26717/BJSTR.2018.03.000909 Santosh Kumar Kamalakannan. Biomed J Sci & Tech Res Cite this article: Masato K. Simple, Rapid and Effective Separation of Nuclear Red Blood Cells from Peripheral Blood of Pregnant Women: Preliminary Study. Biomed J Sci&Tech Res 3(3)- 2018. BJSTR.MS.ID.000909. DOI: 10.26717/BJSTR.2018.03.000909 Introduction Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection and bacteremia in the neonatal period [1]. Neonatal sepsis is a major cause of mortality and neurodevelopmental impairment among neonates. It contributes to nearly 30 % of neonatal deaths in developing countries [2]. Inherent factors like poorly developed innate immune system, immature skin barrier, mucosal defense mechanisms and blood brain barrier contribute to the increased susceptibility of the neonates to infection .Early recognition and aggressive management plays a pivotal role in saving these neonates. Bacterial infections are the most common cause of septicemia in neonates but fungal and viral infections can occur in the setting of an extreme premature baby and by vertical transmission from the mother. Defnition The term neonatal sepsis, refers to a clinical syndrome characterized by the blood stream infection of neonates and inflammatory response mounted by the neonate , it usually presents as septicemia, pneumonia, meningitis, and rarely as arthritis, osteomyelitis, and urinary- tract infection. Superficial infections like oral thrush and pustules are generally termed as local infections. Classifcation Based on the time of onset neonatal sepsis has been traditionally classified as [3]. a. Early onset Neonatal sepsis (EOS), defined as onset of manifestations is within 72 hours of birth. b. Late onset Neonatal sepsis (LOS) is defined as onset of manifestations after 72 hours of life. This classification helps in guiding the antibiotic therapy as it indicates the differences in the presumed mode of transmission and predominant organisms. EOS is mostly results due to vertical transmission of organisms from mothers to infants during the antepartum and intrapartum period and LOS is attributed to the horizontal transmission of pathogens acquired postnatally from the hospital environment or from the community. Vulnerability of the Neonate a. Immature innate immune system: Reduced phagocytic and opsonisation activity, low complement levels, and immature cell mediated and humoral immunity. b. Poor barrier to infection: Fragile immature skin easily susceptible to invasion of organism ,immature mucosal barriers and reduced levels if secretory immunoglobulins ,immature ciliary function with reduced ability to clear secretions and poorly developed blood brain barrier. Risk Factors Early onset Neonatal sepsis (EOS): Presence of the following risk factors has been associated with an increased risk of EOS [3,4]. a. Low birth weight (<2500gms) or prematurity. b. Febrile illness in the mother 2 weeks prior to delivery. c. Foul smelling and/or meconium stained liquor. d. Prolonged rupture of membrane (>24 hours). e. More than 3 vaginal examinations during labor. f. Prolonged and difficult delivery with instrumentation. Mini Review Open Access Abbreviations: EOS: Early Onset Neonatal Sepsis; LOS: Late onset Neonatal Sepsis; NEC: Necrotizing Enterocolitis; RDS: Respiratory Distress Syndrome; UTI: Urinary Tract Infection; GCSF: Granulocyte Colony-Stimulating Factor