title: Neonatal early-onset sepsis evaluations among well-appearing infants: projected impact of changes in CDC GBS guidelines.
abstract: OBJECTIVE
  To determine (a) the proportion of asymptomatic infants born at ≥35 weeks gestation evaluated for early-onset sepsis (EOS) and exposed to postnatal antibiotics; (b) reasons for and outcomes of the evaluations, and (c) anticipated changes when applying the Centers for Disease Control and Prevention (CDC) 2010 guidelines to this study population.
  
  
  METHODS
  Retrospective cohort study of infants born at ≥35 weeks gestation in 2008-2009 in a large maternity center.
  
  
  RESULTS
  Out of the 7226 infants that met the study criteria: 1062 (14.7%) were evaluated for EOS and half of those evaluated, received empiric antibiotics. 70.4% of evaluations were performed owing to maternal intrapartum fever, but 23% were prompted by inadequate Group B Streptococcus (GBS) prophylaxis alone. Three cases of blood culture-proven infection were identified.
  
  
  CONCLUSIONS
  Improved approaches are needed to identify asymptomatic infants who are at risk for EOS to decrease unnecessary evaluations and antibiotic exposure. Transition to the 2010 CDC GBS guidelines may eliminate a quarter of EOS evaluations among these infants.
authors: Division of Newborn Medicine, Children's Hospital Boston, Boston, MA, USA.
authors: S
authors: S
authors: Mukhopadhyay
authors: E C
authors: EC
authors: Eichenwald
authors: K M
authors: KM
authors: Puopolo
mesh_terms: D017668:Age of Onset; D019072:Antibiotic Prophylaxis; D058070:Asymptomatic Diseases; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D015997:Neonatal Screening; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000453:epidemiology* / Q000517:prevention & control; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D013292:Streptococcus agalactiae; D014481:United States