particularly fragile group of patients, making a timely diagnosis and therapy of
sepsis, all the more important.
Surgical neonates with sepsis may be classifies into 3 categories:
- Those at risk for early onset infections, sustained via trans-placental or
vaginal route, during gestation and delivery. This is often a
consideration in infants who require urgent interventions within 72
hours of delivery, for example those with tracheo-esophageal fistula or
imperforate anus, and who decompensate in the early post-operative
period. Distinguishing early onset sepsis from post-operative
complications, such as anastomotic leak, guides much of the
diagnostic work-up in this population. - Those whose source is clearly “surgical,” such as neonates with
complicated necrotizing enterocolitis or malrotation with volvulus, and
who require immediate surgical intervention. - Those who are several days or even weeks into their post-operative
period, at risk for post-operative complications, such as surgical site
infections, or healthcare associated infections, such as line sepsis,
ventilator associated
pneumonia, or urinary tract infection.