What is late-onset neonatal sepsis categorized?

Updated: Jun 13, 2019
  • Author: Nathan S Gollehon, MD, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Late-onset sepsis occurs at 4-90 days of life and is acquired from the environment. Organisms that have been implicated in late-onset sepsis include the following:

  • Coagulase-negative Staphylococcus

  • E coli

  • Klebsiella

  • Enterobacter

  • Candida

  • GBS

  • Serratia

  • Acinetobacter

  • Anaerobes

  • Many additional less-common organisms

Trends in late-onset sepsis show an increase in coagulase-negative streptococcal sepsis, with most isolates showing susceptibility to first-generation cephalosporins. [2] The infant’s skin, respiratory tract, conjunctivae, gastrointestinal tract, and umbilicus may become colonized via contact with the environment or caregivers.

Pneumonia is more common in early-onset sepsis, whereas meningitis and bacteremia are more common in late-onset sepsis. Early-onset sepsis is 10 to 20 times more likely to occur in premature, very low birthweight infants. [6] Premature infants often have nonspecific, subtle symptoms; considerable vigilance is therefore required in these patients so that sepsis can be identified and treated in a timely manner.

For patient education information, see Sepsis.

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