Nagoba BS, Dhotre SV, Sonar MN, Mumbre SS, Gavkare AM, Dhotre PS. Neonatal and pediatric sepsis: Microbiological insights, diagnostic innovations, and antimicrobial challenges. World J Clin Pediatr 2025; 14(4): 107974 [DOI: 10.5409/wjcp.v14.i4.107974]
Corresponding Author of This Article
Basavraj S Nagoba, PhD, Professor, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. dr_bsnagoba@yahoo.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Dec 9, 2025; 14(4): 107974 Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.107974
Neonatal and pediatric sepsis: Microbiological insights, diagnostic innovations, and antimicrobial challenges
Basavraj S Nagoba, Shree V Dhotre, Mahesh N Sonar, Sachin S Mumbre, Ajay M Gavkare, Pradnya S Dhotre
Basavraj S Nagoba, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, Maharashtra, India
Shree V Dhotre, Department of Microbiology, Ashwini Rural Medical College, Solapur 413006, Maharashtra, India
Mahesh N Sonar, Department of Pediatrics, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, Maharashtra, India
Sachin S Mumbre, Department of Community Medicine, Ashwini Rural Medical College, Solapur 413006, India
Ajay M Gavkare, Department of Physiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Latur 413531, Maharashtra, India
Pradnya S Dhotre, Department of Biochemistry, Ashwini Rural Medical College, Solapur 413006, India
Co-first authors: Basavraj S Nagoba and Shree V Dhotre.
Author contributions: Nagoba BS designed the overall concept and outline of the manuscript; Dhotre SV, Gavkare AM, Mumbre SS, and Dhotre PS contributed to the discussion and design of the manuscript; Nagoba BS, Dhotre SV, and Gavkare AM contributed to the writing and editing the manuscript and review of the literature; All of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Basavraj S Nagoba, PhD, Professor, Department of Microbiology, Maharashtra Institute of Medical Sciences and Research (Medical College), Vishwanathpuram, Ambajogai Road, Latur 413531, Maharashtra, India. dr_bsnagoba@yahoo.com
Received: April 3, 2025 Revised: April 21, 2025 Accepted: June 7, 2025 Published online: December 9, 2025 Processing time: 211 Days and 23 Hours
Abstract
Neonatal and pediatric sepsis remains a major global health concern, contributing significantly to morbidity and mortality among children under 5 years of age. The clinical and microbiological characteristics of sepsis differ markedly in neonates and children, necessitating tailored diagnostic and treatment approaches. This mini-review explores the evolving microbiological landscape, recent advancements in diagnostic methodologies, and challenges posed by antimicrobial resistance (AMR) in managing neonatal and pediatric sepsis. Emerging pathogens, including multidrug-resistant Gram-negative bacilli and fungal organisms, are reshaping the epidemiology of sepsis. Innovations in molecular diagnostics, including polymerase chain reaction-based platforms, next-generation sequencing, and artificial intelligence-integrated tools, are revolutionizing early pathogen detection and resistance profiling. However, implementation gaps persist, particularly in low- and middle-income countries. Therapeutic challenges are compounded by limited pediatric data on newer antimicrobials and rising AMR rates. Infection prevention strategies, especially in intensive care units, are crucial to outbreak containment. An integrated approach combining microbiological surveillance, rapid diagnostics, and antimicrobial stewardship is critical for improving sepsis outcomes. Future research should focus on context-specific implementation of diagnostic tools and optimizing treatment strategies for resource-limited settings.
Core Tip: Neonatal and pediatric sepsis is a major contributor to global child mortality, with significant challenges in timely and accurate diagnosis. Traditional blood culture methods have limitations, necessitating advancements in molecular diagnostics and biomarker-based approaches. Emerging technologies such as metagenomic sequencing and artificial intelligence-driven diagnostic tools offer promising solutions for rapid pathogen identification. Antimicrobial resistance continues to complicate treatment, making antimicrobial stewardship programs crucial in pediatric healthcare. This review highlights microbiological insights, diagnostic advancements, antimicrobial resistance mechanisms, combination therapy strategies, and approaches to improving early detection and outcomes in pediatric sepsis.
