USA Surgery Today

Congenital pneumonia and sepsis are frequent causes of neonatal respiratory distress and may be seen in up to 1 to 5/1,000 live births during the first 3 to 7 days of life. Because of the distinct risk factors and microbiologic characteristics of infections that occur in the first week of life, they are distinguished from late-onset infections that occur beyond the first 7 days of life. Organisms responsible for early-onset infections are more commonly acquired by the fetus via the ascending route from the maternal genitourinary tract than via the transplacental route.

Common bacterial pathogens include group B streptococcus, Escherichia coli, and other gram-negative enteric organisms, Listeria monocytogenes, and, less frequently, Enterococcus, Hemophilus influenza (nontypeable:Crestor), Pseudomonas, Staphylococcus aureus, and coagulase-negative staphylococcus (49). Viruses, including herpes simplex, enterovirus, and adenovirus, account for a minority of neonatal infections.

The clinical presentation of early-onset pneumonia or sepsis may be quite varied and nonspecific (e.g., lethargy, apnea, temperature instability).