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 Vol. 9 No. 12, December 2008
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NeoReviews Vol.9 No.12 2008 e571
© 2008 American Academy of Pediatrics

Epidemiology of Neonatal Early-onset Sepsis

Karen M. Puopolo, MD, PhD*

* Assistant Professor of Pediatrics, Harvard Medical School; Attending Physician, Channing Laboratory and Department of Newborn Medicine, Brigham and Women's Hospital and Division of Newborn Medicine, Children's Hospital, Boston

Neonatal early-onset sepsis (EOS) continues to be a significant source of morbidity and mortality among newborns, especially among very-low birthweight infants. Epidemiologic risk factors for EOS have been defined, and considerable resources are devoted to the identification and evaluation of infants at risk for EOS. The widespread implementation of intrapartum antibiotic prophylaxis for the prevention of early-onset neonatal group B Streptococcus (GBS) disease has reduced the overall incidence of neonatal EOS and influenced the microbiology of persistent early-onset infection. Most early-onset neonatal GBS disease now occurs in preterm infants or in term infants born to mothers who have negative GBS screening cultures. Ongoing clinical challenges include reassessment of clinical risk factors for EOS in the era of GBS prophylaxis; more accurate identification of GBS-colonized women; and continued surveillance of the impact of GBS prophylaxis practices on the microbiology of EOS, particularly among very low-birthweight infants.

Abbreviations: BWH: Brigham and Women's Hospital • CDC: Centers for Disease Control and Prevention • EOS: early-onset sepsis • GBS: group B Streptococcus • IAP: intrapartum antibiotic prophylaxis • MRSA: methicillin-resistant Staphylococcus aureus • NICHD: National Institute of Child Health and Development • NICU: neonatal intensive care unit • PCR: polymerase chain reaction • VLBW: very low birthweight






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