Table 1:

Early-onset sepsis research

Reference	Study Population	Years	Key Points
Stoll, et al. J Pediatr 19967	7,861 VLBW infants	1991–1993 (cohort 1)	EOS rate: 1.9% of VLBW infants; rates varied by BW and GA GBS (31%) most common bacterial isolate E. coli (16%) and H. influenzae (12%) next most common 26% of VLBW infants with EOS died
Stoll, et al. N Engl J Med 20028	5,447 VLBW infants	1998–2000 (cohort 2)	Non-significant decline in EOS rate compared to 1991–1993 cohort (19.3 vs. 15.4 per 1000) E. coli (44%) and GBS (10%) most common bacterial isolates 85% of E. coli isolates resistant to ampicillin EOS associated with higher adjusted risk of death, RDS, severe IVH and BPD
Stoll, et al. Pediatr Inf Dis 20059	5,999 VLBW infants	2002–2003 (cohort 3)	Stable rate of EOS compared to 1998–2000 E. coli most common organism (41%) with stable rates of antibiotic resistance 35% of VLBW infants with EOS died
Stoll, et al. Pediatrics 201111	396,586 infants of all GA	2006–2009 (EOS I)	Most frequent pathogen was GBS (43%), followed by E. coli (29%) Incidence was 0.98 cases per 1000 live births and was highest among VLBWs
Weston, et al. Pediatr Infect Dis J 201112	CDC compared with NRN	2006–2008	Similar pathogen distribution, incidence trends, and case fatality rates comparing CDC and NRN cohorts For both cohorts, GBS isolated in most cases; E. coli isolated in most deaths
Wynn, et al. J Pediatric 201320	34,396 VLBW infants	1998–2009	Overall, risk of LOS or death was not different overall for infants with and without history of EOS Infants born <25 weeks’ GA with EOS had lower risk of LOS
Pappas, et al. JAMA Pediatr 201422	2,390 infants 22–26 weeks GA	2006–2008	Chorioamnionitis associated with lower GA at birth and higher rates of EOS and severe IVH Histologic plus clinical chorioamnionitis associated with increased risk of NDI as compared with no chorioamnionitis
Wortham, et al. Pediatrics 201616	396,586 infants of all GA	2006–2009	Of 229 infants with EOS exposed to chorioamnionitis, 13% had no symptoms by 6 hours after birth, and 9% had no symptoms by 72 hours Estimated 60 to 1400 newborns would receive empiric antibiotics for each infected asymptomatic newborn
Weissman, et al. J Pediatr Dis Soc 201614	28 infants with E. coli EOS	2008–2009	Among E. coli isolates: high rate of ampicillin resistance; low rate of fluoroquinolone resistance; no aminoglycoside resistance 1 isolate resistant to third-generation cephalosporins
Puopolo, et al. Pediatrics 201718	15,433 infants 22–28 weeks GA	2006–2014	37% met “low-risk” criteria based on delivery characteristics EOS incidence was 0.5% in low-risk group vs 2.5% in comparison group Prolonged antibiotics were administered to 34% of uninfected low-risk infants versus 47% of uninfected comparison infants
Stoll, et al. JAMA Pediatr 202013	217,480 infants of all GA	2015–2017 (EOS II)	Incidence was 1.08 per 1000 live births and varied significantly by GA Most frequent pathogen was E. coli (37%), followed by GBS (30%) Rate of E. coli among VLBW infants increased compared to EOS I cohort
Mukhopadhyay, et al. J Pediatr 202021	6,565 infants 22–26 weeks’ GA	2006–2014	EOS associated with increased risk of death/NDI Among matched infants without EOS, prolonged early antibiotic administration was not associated with death/NDI
Flannery, et al. Pediatr Infect Dis J 202215	217,480 infants of all GA	2015–2017 (secondary analysis)	8% of EOS isolates suboptimally treated with ampicillin and gentamicin Resistant EOS infections more common among preterm, VLBW infants

Footnotes: Studies listed in order of publication. BPD (bronchopulmonary dysplasia); BW (birthweight); CDC (Centers for Disease Control and Prevention); ELBW (extremely low birth weight); EOS (early onset sepsis); GA (gestational age); GBS (Group B Streptococcus); IVH (intraventricular hemorrhage); NDI (neurodevelopmental impairment); NEC (necrotizing enterocolitis); NRN (Neonatal Research Network); RDS (respiratory distress syndrome); VLBW (very low birth weight)