Neonatal infections Effects on the neonate and how they can be prevented

Neonatal sepsis remains one of the leading causes of death in the neonatal period worldwide. In addition to high mortality, affected infants are threatened by short-term and long-term morbidities. Inflammation in the setting of an infection can lead to damage of various organ systems with corresponding sequelae. In this context, the duration of the inflammation reaction in particular is decisive. In addition, the antibiotic therapy necessary in sepsis modifies the postnatal development of the infant's microbiome, which can sustainably disrupt the immune development. The consequence is an increased risk for renewed infections or immune-mediated noncommunicable diseases, such as asthma, allergies, diabetes and autoimmune diseases. Established prevention strategies include early enteral nutrition with breast milk, avoidance of invasive catheters and procedures, strict hygiene concepts including colonization monitoring and cohorting measures in the neonatal intensive care unit, as well as antibiotic stewardship programs to avoid unnecessary antibiotic therapy. New concepts such as nutritional supplementation with S100 alarmins and probiotics or the use of monoclonal antibodies and maternal immunization against pathogens causing sepsis are currently being investigated in studies for their sepsis-protective effect in premature and newborn infants.