Neonatal sepsis: Recent advances in pathophysiology and management

Neonatal sepsis is an infection-related clinical condition that appears in the first 4 weeks of life. It is a complex syndrome marked by inflammatory responses with unknown pathophysiology. In the current condition, it is a leading cause of newborn morbidity and mortality in underdeveloped countries. Even though neonates have a robust immune system to resist infections, sepsis is caused by bacterial, fungal, or viral infection that triggers the host immunological response. Epigenetic variations like DNA methylation is induced by infection, which leads to alterations in gene expression. MicroRNAs (miRNAs) also control the gene expression and act as a promising biomarker for sepsis. IL-10, TLR4, TNF-α, IL-6 genetic polymorphisms are all associated with sepsis and have an impact on the prognosis. Early diagnosis and appropriate management improves the outcome in neonatal sepsis.