THE ROLE OF IMMUNODEFICIENCY IN THE DEVELOPMENT OF POSTOPERATIVE BACTERIAL SEPSIS AND WOUND INFECTIONS IN NEONATES

Newborn infants are predisposed to bacterial invasion. Several defects in antibacterial host immunity have been reported that are relevant t o the management of the neonate requiring surgical intervention. Defec ts in the quantities and function of immunoglobulins, complement compo nents, and neutrophils are described that, in combination, render neon ates immunocompromised. Consequently, neonates are susceptible to infe ction with bacteria that are usually of low virulence such as coagulas e-negative staphylococci. Coagulase-negative staphylococci are usually resistant to both ampicillin and gentamicin, the antibiotics most com monly used for perioperative prophylaxis in neonates. Since the neonat e is an immunocompromised host, controlled trials should be conducted to determine the optimal choice, dose, and duration of prophylactic an tibiotics required to minimize post-operative infection while also min imizing superinfections resulting from antibiotic usage.