No cases of proven early-onset sepsis found in low-risk preterm infants

A retrospective study of 554 extremely preterm infants (22-29 weeks' gestation) at a single US hospital from 2018-2023 examined risk factors for early-onset sepsis, defined by positive blood culture within 72 hours. The study reported that prelabor preterm rupture of membranes and acute chorioamnionitis on placental pathology were more common among infants with proven or suspected sepsis than controls, and that none of the infants with proven sepsis met criteria for low risk (cesarean delivery without labor, rupture of membranes at delivery, and no chorioamnionitis). The authors concluded that risk assessment for early-onset sepsis should be promoted to enhance antibiotic stewardship.

Most relevant for: Extremely preterm infants (22-29 weeks' gestation) being evaluated for early-onset sepsis and antibiotic initiation in the neonatal intensive care setting.

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