Systemic infection

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In antiquity, transmission of disease was attributed to the miasma or contagion theory. In the Middle Ages, living in proximity to domestic animals and flies, the scarce use of soap, and absent sewage augmented the exposure to bacteria. In the early 19th century, Gordon, Holmes, and Semmelweis understood that maternal childbed fever—closely related to neonatal sepsis—was transferred by the physician’s hands to the mother during delivery. Before bacteria were discovered in the mid-19th century, septic infections in the newborn were perceived as different disorders: erysipelas, Buhl’s disease, Winckel’s disease, and so on. With the advent of microbiology, sepsis became heterogeneous and was mainly defined by the causing microorganism. In the 1940s, group B streptococci emerged as a pathogen of newborns and soon became the commonest cause of neonatal sepsis. The discovery of antibiotics made the deadly disease treatable. In the 1970s, resistant bacterial strains emerged and allied dangerously with indwelling devices, especially central venous catheters. In the developing world, neonatal sepsis remains a major cause of infant mortality.