TABLE 94.2.

Pathogens That Commonly Cause Late-Onset Sepsis in the Neonatal Intensive Care Unit

Pathogen	Relative Frequency of Isolation	Comment
CoNS	+++	Most common cause of CLABSI but decreasing with implementation of multipronged infection prevention
Staphylococcus aureus	++	Highest rate of focal complications; MRSA is a problem in some NICUs
Candida species	++	Candida albicans and C, parapsilosis are the most common species
Enteric GNR	++	Most common cause of fulminant sepsis; Klebsiella species is the most common GNR
Pseudomonas aeruginosa	+	GNR with highest case-fatality rate
Enterococcus species	+	Increased in importance as a nosocomial pathogen since the 1990s
Group B streptococci	+	Rate of late-onset cases unchanged, in contrast to dramatic decrease in early-onset cases with intrapartum antibiotics

CoNS, Coagulase-negative staphylococci; CLABSI, central line–associated bloodstream infection; GNR, gram-negative rods; MRSA, methicillin-resistant Staphylococcus aureus; NICU, neonatal intensive care unit; +++, most frequently isolated; ++, commonly isolated; +, occasionally isolated.