Early-Onset Sepsis Rates in Newborns Determined

Current early-onset sepsis rates among newborns, the pathogens involved, and associated morbidity and mortality were determined in the United States.

The multisite national study demonstrated that the most frequent pathogens associated with sepsis were group B streptococci (GBS) in full-term infants and Escherichia coli in preterm infants.

Nearly 400,000 newborns were included in the study, which also found that infection rates increased with decreasing gestational age and birth weight. The overall rate of infection was 0.98 per 1,000 live births; 0.41 per 1,000 live births involving GBS and 0.28 per 1,000 live births involving E. coli.

Bloodstream infections in newborns can lead to serious complications with substantial morbidity and mortality. The pathogens responsible for neonatal infections have changed over time. In recent years, however, antibiotic prophylaxis given to at-risk mothers has reduced the incidence of early-onset group B streptococcal infections among their babies.

"Infections occur in almost one case per thousand live births," said Barbara Stoll, MD, lead investigator for the study. Prof. Stoll is the George W. Brumley, Jr., professor and chair, Department of Pediatrics in Emory University School of Medicine (Atlanta, GA, USA). "With approximately 4 million births a year in the United States, this equates to a substantial burden of disease. We estimate that approximately 3,000 infants a year develop early-onset sepsis. With current mortality rates, approximately 300 to 350 deaths per year are associated with neonatal sepsis. So, it's not inconsequential."

The study also shows that opportunities for prevention of neonatal GBS infections continue to be missed. "Missed opportunities for prevention of GBS include failure to screen all women who deliver at term, failure to provide antibiotics to all colonized women or to those who delivered preterm with unknown colonization status, and false negative GBS screens among women who deliver with GBS infection," added Prof. Stoll.


The study appeared online on April 25, 2011 and in the May 2011 issue of Pediatrics.

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Emory University School of Medicine