One serious problem confronting the pediatrician is neonatal septicemia and meningitis. In one institution, despite the introduction of multiple new antibiotics, morbidity and mortality of newborn infants with acute bacterial diseases has increased significantly over the past five years. Moreover, the pattern of infection has changed; presently, the predominant etiologic agents are gram-negative organisms such as Escherichia coli, Pseudomonas aeruginosa and Aerobacter aerogenes, rather than strains of staphylococcus or streptococcus.
The pathogenesis of gram-negative septicemia in the newborn is not clear; however, the increasing use of mechanical devices in the nursery, coupled with the ease with which these instruments are contaminated, causes concern throughout the country. As the use of respirators, resuscitators, incubators, and catheters increases in the "intensive care" now directed toward neonates, the hazard of septicemia also increases. Not surprisingly, septic complications are most frequent and most severe in infants born with associated perinatal complications, particularly prematurity.