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Early-Onset Sepsis

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Abstract

Early-onset sepsis (EOS) remains a major cause of neonatal morbidity and mortality. Even in the era of universal group B Streptococcus (GBS) screening and intrapartum antibiotic prophylaxis, EOS due to GBS and gram-negatives such as Escherichia coli is common. Both maternal and neonatal risk factors can be used to guide decisions regarding diagnostic evaluations and empiric antibiotic therapy for EOS. Prevention can be optimized by providing adequate prenatal care, reducing preterm deliveries, and providing intrapartum antibiotic prophylaxis when warranted.

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References

  1. Shane AL, Sanchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017;390:1770–80.

    Article  PubMed  Google Scholar 

  2. Schrag SJ, Farley MM, Petit S, et al. Epidemiology of invasive early-onset neonatal sepsis, 2005 to 2014. Pediatrics. 2016;138:e20162013.

    Article  PubMed  Google Scholar 

  3. Stoll BJ, Hansen NI, Sanchez PJ, et al. Early onset neonatal sepsis: the burden of group B streptococcal and E coli disease continues. Pediatrics. 2011;127:817–26.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Higgins RD, Saade G, Polin RA, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: summary of a workshop. Obstet Gynecol. 2016;127:426–36.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Wortham JM, Hansen NI, Schrag SJ, et al. Chorioamnionitis and culture-confirmed, early-onset neonatal infections. Pediatrics. 2016;137:e20152323.

    Article  PubMed Central  Google Scholar 

  6. Kuzniewicz MW, Puopolo KM, Fischer A, et al. A quantitative, risk-based approach to the management of neonatal early-onset sepsis. JAMA Pediatr. 2017;171:365–71.

    Article  PubMed  Google Scholar 

  7. Weintraub AS, Cadet CT, Perez R, et al. Antibiotic use in newborns with transient tachypnea of the newborn. Neonatology. 2013;103:235–40.

    Article  PubMed  CAS  Google Scholar 

  8. Shani L, Weitzman D, Melamed R, et al. Risk factors for early sepsis in very low birth weight neonates with respiratory distress syndrome. Acta Paediatr. 2008;97:12–5.

    Article  PubMed  Google Scholar 

  9. Dempsey EM, Barrington KJ. Diagnostic criteria and therapeutic interventions for the hypotensive very low birth weight infant. J Perinatol. 2006;26:677–81.

    Article  PubMed  CAS  Google Scholar 

  10. Polin RA. Committee on fetus and newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics. 2012;129:1006–15.

    Article  PubMed  Google Scholar 

  11. Cantey JB, Baird SD. Ending the culture of culture-negative sepsis in the neonatal ICU. Pediatrics. 2017;140:e2017044.

    Article  Google Scholar 

  12. Lu Q, Zhou M, Tu Y, Yao Y, Yu J, Cheng S. Pathogen and antimicrobial resistance profiles of culture-proven neonatal sepsis in Southwest China, 1990-2014. J Paediatr Child Health. 2016;52:939–43.

    Article  PubMed  Google Scholar 

  13. Bizzaro MJ, Dembry LM, Baltimore RS, Gallagher PG. Changing patterns in neonatal Escherichia coli sepsis and ampicillin resistance in the era of intrapartum antibiotic prophylaxis. Pediatrics. 2008;121:689–96.

    Article  Google Scholar 

  14. Heideking M, Lander F, Hufnagel M, et al. Antibiotic susceptibility profiles of neonatal invasive isolates of Escherichia coli from a 2-year nationwide surveillance study in Germany, 2009-10. Eur J Clin Microbiol Infect Dis. 2013;32:1221–3.

    Article  CAS  PubMed  Google Scholar 

  15. Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T. Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO’s currently recommended antibiotics – systematic review and meta-analysis. Arch Dis Child. 2013;98:146–54.

    Article  PubMed  Google Scholar 

  16. Greenhow TL, Cantey JB. The disputed champion: ampicillin and gentamicin for febrile young infants. Hosp Pediatr. 2017; Available online Jul 20 2017.

    Google Scholar 

  17. Johnson SJ, Ernst EJ, Moores KG. Is double coverage of gram-negative organisms necessary? Am J Heatlh Syst Pharm. 2011;68:119–24.

    Article  Google Scholar 

  18. Stockmann C, Spigarelli MG, Campbell SC, et al. Considerations in the pharmacologic treatment and prevention of neonatal sepsis. Pediatr Drugs. 2014;16:67–81.

    Article  Google Scholar 

  19. Mohan P, Brocklehurst P. Granulocyte transfusions for neonates with confirmed or suspected sepsis and neutropaenia. Cochrane Database Syst Rev. 2003;4:CD003956.

    Google Scholar 

  20. INIS Collaborative Group, Brocklehurst P, Farrell B, et al. Treatment of neonatal sepsis with intravenous immune globulin. N Engl J Med. 2011;265:1201–11.

    Google Scholar 

  21. Pammi M, Haque KN. Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates. Cochrane Database Syst Rev. 2015;3:CD004205.

    Google Scholar 

  22. Carr R, Brocklehurst P, Dore CJ, Modi N. Granulocyte-macrophage colony stimulating factor administered as prophylaxis for reduction of sepsis in extremely preterm, small for gestational age neonates (the PROGRAMS trial): a single-blind, multicenter, randomised controlled trial. Lancet. 2009;373:226–33.

    Article  PubMed  CAS  Google Scholar 

  23. Clifford V, Garland SM, Grimwood K. Prevention of neonatal group B streptococcus disease in the 21st century. J Paediatr Child Health. 2012;48:808–15.

    Article  PubMed  Google Scholar 

  24. Vergnano S, Embleton N, Collinson A, Menson E, Russell AB, Heath P. Missed opportunities for preventing group B streptococcus infection. Arch Dis Child Fetal Neonatal Ed. 2010;95:F72–3.

    Article  PubMed  CAS  Google Scholar 

  25. Van Dyke MK, Phares CR, Lynfield R, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009;360:2626–36.

    Article  PubMed  Google Scholar 

  26. Baker CJ. Vaccine prevention of group B streptococcal disease. Pediatr Ann. 1993;22:711–4.

    Article  PubMed  CAS  Google Scholar 

  27. Vekemans J, Moorthy V, Friede M, et al. Maternal immunization against Group B streptococcus: World Health Organization research and development technological roadmap and preferred product characteristics. Vaccine. 2018; Available online Feb 2 2018.

    Google Scholar 

  28. Shapiro-Mendoza CK, Barfield WD, Henderson Z, et al. CDC grand rounds: public health strategies to prevent preterm birth. MMWR Morb Mortal Wkly Rep. 2016;65:826–30.

    Article  PubMed  Google Scholar 

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Correspondence to Susan A. Lee MD .

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Lee, S.A. (2018). Early-Onset Sepsis. In: Cantey, J. (eds) Neonatal Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-90038-4_1

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  • DOI: https://doi.org/10.1007/978-3-319-90038-4_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90037-7

  • Online ISBN: 978-3-319-90038-4

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