- EOS —
- early-onset sepsis
A 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 <2%, the incidence of long-term neurologic sequelae can be as high as 50%.1,2
A baseline risk of <1 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.
Address correspondence to James J. Cummings, MD, MS, Vice Chair and Professor of Pediatrics, The Bernard & Millie Duker Children’s Hospital at Albany Medical Center, 43 New Scotland Ave, Mailstop 88, Albany, NY 12208. E-mail: