Early-onset sepsis in term infants admitted to neonatal intensive care units (2011–2016)

OBJECTIVES: Investigate characteristics of term infants culture-evaluated for early-onset sepsis (EOS) in neonatal intensive care units (NICUs), frequencies of organisms causing EOS, and factors associated with EOS. STUDY DESIGN: Using a cohort design, we identified term infants evaluated for EOS with blood, cerebrospinal fluid, or urine cultures in 326 NICUs (2011–2016). Using multivariable logistic regression, we investigated the association between EOS and demographic characteristics. RESULTS: Of 142,410 infants, 1197 (0.8%) had EOS, most commonly caused by group B Streptococcus (GBS; 40.6%). Lower EOS risk was associated with low Apgar score, Cesarean delivery, small for gestational age, prenatal antibiotic exposure, and positive or unknown maternal GBS screening result. Increased risk was associated with prolonged rupture of membranes, maternal age <19 years, vasopressor treatment, and ventilator support. CONCLUSION(S): GBS was the most frequent cause of EOS. Early risk factor recognition may help daily management of term infants in NICUs.