The Well-Appearing Newborn At Risk For Early-Onset Sepsis: We Can Do Better

* Abbreviation: EOS — : early-onset sepsisA common question in the newborn nursery is when to do a sepsis evaluation. When one considers pathogens such as group B Streptococcus , the risk of invasive infection is higher in the newborn than at any other time of life.1 Overall, the incidence of early-onset sepsis (EOS, defined as a positive blood or cerebrospinal fluid culture within the first 72 hours after birth) in infants born at term is estimated to be ∼1 per 2000.2 Although case fatality rates are u003c2%, the incidence of long-term neurologic sequelae can be as high as 50%.1,2A baseline risk of u003c1 per 1000 may be too low to justify routine evaluation for EOS, but perinatal factors can significantly increase that risk. Questions then arise: Whom to test, when to treat with antibiotics pending test results, when to perform a lumbar puncture, and how long to treat with antibiotics if cultures remain negative? In an effort to aid the clinician, guidelines3,4 and risk-based tools5,6 have been developed.How … Address correspondence to James J. Cummings, MD, MS, Vice Chair and Professor of Pediatrics, The Bernard u0026 Millie Duker Children’s Hospital at Albany Medical Center, 43 New Scotland Ave, Mailstop 88, Albany, NY 12208. E-mail: cumminj1{at}mail.amc.edu