Newborn Sepsis and Meningitis

• Group B streptococcus and Escherichia coli account for most of the cases of neonatal early-onset bacterial sepsis. • Prevention of infection by maternal treatment is the main factor accounting for the decreased incidence of early-onset group B streptococcus sepsis. • Microbiologic cultures represent the mainstay for diagnosis of infection. • Management of the asymptomatic newborn at risk of infection because of maternal risk factors is in transition, with recent evidence supporting evaluation and treatment of a small proportion of asymptomatic infants. • Ampicillin and gentamicin are recommended as initial therapy in neonates with suspected bacterial sepsis. Treatment can then be narrowed appropriately on the basis of the results of antibiotic susceptibility studies.