Neonatal and pediatric sepsis: Microbiological insights, diagnostic innovations, and antimicrobial challenges

Table 1 Pathogen distribution in early-onset sepsis, late-onset sepsis, and pediatric sepsis[13,14]

Sepsis type	Common pathogens
Early-onset sepsis	Group B Streptococcus, Escherichia coli, Listeria monocytogenes
Late-onset sepsis	Klebsiella pneumoniae, Staphylococcus aureus, Candida spp.
Pediatric sepsis	Pseudomonas aeruginosa, Enterobacter spp., MRSA

MRSA: Methicillin-resistant Staphylococcus aureus.

Table 2 Common pathogens in neonatal and pediatric sepsis by region and comorbidity[15,16]

Region/Condition	Neonatal sepsis - common pathogens	Pediatric sepsis - common pathogens
Developed countries	Group B Streptococcus, Escherichia coli, Listeria spp.	Streptococcus pneumoniae, Neisseria meningitidis, MRSA
Developing countries	Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli	Salmonella spp., Staphylococcus aureus, Pseudomonas aeruginosa
NICU/PICU settings	MDR Klebsiella, Candida albicans, Enterococcus spp.	Acinetobacter, Stenotrophomonas maltophilia
Immunocompromised children	Pseudomonas aeruginosa, Candida parapsilosis	Nocardia, Fusarium, Aspergillus, MDR GNB

GNB: Gram-negative bacilli; MDR: Multidrug-resistant; MRSA: Methicillin-resistant Staphylococcus aureus; NICU: Neonatal intensive care units; PICU: Pediatric intensive care unit.

Table 3 Traditional vs emerging diagnostic techniques for neonatal and pediatric sepsis[48]

Diagnostic method	Turnaround time	Sensitivity/Specificity	Key advantages	Limitations
Blood culture	48-72 hours	Moderate	Gold standard, organism isolation	Low yield in neonates, slow
C-reactive protein	< 6 hours	Low-moderate	Widely available	Non-specific
Procalcitonin	< 6 hours	Moderate-high	Early rise in bacterial infections	Cost, variation by age
PCR-based panels	1-3 hours	High	Pathogen-specific, rapid results	Limited panels, cost
Next-generation sequencing	24-48 hours	High	Broad-range, detects rare pathogens	Expensive, needs expertise
Artificial intelligence-driven tools	Real-time	Evolving	Integration with clinical data	Limited pediatric validation

PCR: Polymerase chain reaction.