Clinical Case Database / Category: Clinical Care

Infections & necrotising enterocolitis in newborn Infants

Publication details

Dr Thomas Skeath, Dr Nicholas Embleton
Foundation Years Journal, volume 8, issue 8, p.26 (123Doc Education, London, September 2014)


Sepsis and necrotising enterocolitis are the most prevalent, yet potentially preventable causes of serious perinatal morbidity and mortality within the neonatal period. 1 in 10 deaths in infants born <32 weeks gestation is due to infection (1). There is a wide range of conditions leading to illness in the neonatal period, but gestation and age at presentation are important factors in terms of the key morbidities, and infections are normally described using these categories. Premature or preterm delivery (<37 completed weeks gestation) is associated with different risk factors to those born at term. Early Onset Sepsis (EOS) occurs in the first 2-3 days of life, whereas Late Onset Sepsis (LOS) occurs thereafter and is usually caused by organisms acquired after delivery.

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Dr Thomas Skeath (Corresponding author)

Clinical Research Fellow RVI Newcastle
Neonatal Department
Royal Victoria Hospital
Queen Victoria Road
Newcastle Upon Tyne

Dr Nicholas Embleton

Consultant Neonatologist
Neonatal Department
Royal Victoria Hospital
Queen Victoria Road
Newcastle Upon Tyne


1.  Vergnano S1, Menson E, Kennea N, Embleton N, Russell AB, Watts T, Robinson MJ, Collinson A, Heath PT. Arch Dis Child Fetal Neonatal Ed. 2011 Jan;96(1):F9-F14. Neonatal infections in England: the NeonIN surveillance network.

2.  Stoll B.J., Hansen N.I., Adams-Chapman I., Fanaroff A.A., Hintz S.R., Vohr B., Higgins R.D. et National Institute of Child Health and Human Development Neonatal Research Network. (2004). Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA, 292(19), 2357–2365.

3.  National Institute for Health and Clinical Excellence. Antibiotics for early-onset neonatal infection: antibiotics for the prevention and treatment of early-onset neonatal infection. London: NICE; 2012. Available from:

4.  Michael P. Sherman, Lactoferrin and Necrotizing Enterocolitis. Clin Perinatol. Mar 2013; 40(1): 79–91.

5.  The INIS Collaborative Group. Treatment of Neonatal Sepsis with Intravenous Immune Globulin. N Engl J Med 2011; 365:1201-1211September 29, 2011.

6.  Westerbeek EAM, Van den Berg JP, Lafeber HN, Fetter-Wilem PF, Boehm G, Twisk WR, Van Elburg RM: Neutral and acidic oligosaccharides in preterm infants: a randomized double-blind, placebo controlled trial. Am J Clin Nutr 2010, 91:679–686.

7.  Kempley S, Gupta N, Linsell L, Dorling J, McCormick K, Mannix P, Juszczak E, Brocklehurst P, Leaf A; ADEPT Trial Collaborative Group. Feeding infants below 29 weeks’ gestation with abnormal antenatal Doppler: analysis from a randomised trial. Arch Dis Child Fetal Neonatal Ed. 2014 Jan;99(1):F6-F11. doi: 10.1136/archdischild-2013-304393. Epub 2013 Aug 23.


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