Neonatal sepsis: evaluation and management.

Bacterial antigenic challenge presents a difficult fight for the neonatal immune system, and they have a smaller arsenal of weapons to fight bacterial infections than adults and older children. The baby's own systemic inflammatory response may have detrimental effects on several organs and longer lasting effects on the developing brain. Neurodevelopmental outcomes after maternal chorioamnionitis are worse than neonates without a contaminated intrauterine environment, regardless of gestation age and the baby's culture results. Successes with intrapartum antibiotic prophylaxis decreasing rates of GBS sepsis and maternal chorioamnionitis, have heartened care providers and parents. These results demonstrate the advances possible when specific diseases are made a national health priority, and good clinical trial work is applied to clinical practice.

Update on neonatal resuscitation.

Pediatricians and other practitioners who attend deliveries maintain resuscitation skills throughout their careers. NRP certification and continuing education programs (PCEP) have done much to standardize the care a newborn receives in the first minutes after birth. Neonates have benefited tremendously from strong national programs (NRP and PCEP) with great local execution of training modules.