Epidemiology, Biomarkers, Prevention and Therapy in Neonatal Infectious Diseases: From Empirical to Personalized Approach

Dear Colleagues,

Infectious diseases represent one of the main causes of morbidity and mortality worldwide in neonatal population. Studies carried out in recent decades have shown significant changes in the field of infectious disease epidemiology, diagnostic investigations, prevention and therapeutic strategies. Concerning epidemiology, it is becoming increasingly evident that the incidence of different pathogens varies not only between different countries, but also between different hospitals within the same city. This discrepancy is likely attributable to a multitude of factors, including the absence of a universally accepted definition of neonatal sepsis and the utilization of disparate methodologies in disparate healthcare settings. Moreover, research focusing on individual biological and genetic variations has the potential to facilitate the development of personalized medicine.

One of the pivotal aspects of neonatal infection management is the determination of the optimal timing for the initiation and cessation of antibiotic therapy. This is due to the inherent limitations of the newborn immune system, the rapid progression of certain infectious processes, and the lack of clear and definitive clinical signs of infection in newborns. One of the challenges in this field of research is the identification of biomarkers that can be used to diagnose infections in a sensitive and specific manner. Procalcitonin, IL-6, and C-reactive protein are widely used, but they have neither sufficient sensitivity nor sufficient negative predictive power to be considered the ideal biomarkers of neonatal infection. Recent omics-based studies (transcriptomics, proteomics or metabolomics studies) have identified distinct transcriptional signatures, and metabolic or proteomic biomarkers associated with sepsis, which seem specific for each category of individuals. Finally, in recent years, studies are focusing on personalized pharmacology, with the aim of the correct use of drugs, which may vary from patient to patient for the different metabolic abilities, specific to the individual.

Infectious diseases in neonates are a persistent challenge for clinicians and researchers from every point of view. This special issue aims to collate the different and updated evidence on the approach to neonatal infections, to shed a light on the advancements, challenges, and future directions in this field.

Dr. Vito Mondı̀
Dr. Cinzia Auriti
Dr. Chryssoula Tzialla
Prof. Dr. Fiammetta Piersigilli
Guest Editors

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• pharmacology in the newborn
• new biomarkers in neonatal infections
• epidemiology of neonatal infections
• omics in neonatal infections
• prevention of neonatal infections