[Practical management of neonatal sepsis risk in term or near-term infants]

Abstract

Incidence of neonatal early-onset sepsis has dramatically declined in France from 0.65 to 0.23‰ live births in 10 years since national guidelines to detect and treat intrapartum women with group B streptococcus colonization have been adopted. However, neonatal early-onset sepsis continues to be a common healthcare burden. Group B streptococcus (GBS) remains the leading cause of bacterial infection in term or near-term infants. As a result of prevention strategies, approximately 30% of pregnant women and more than 2% of newborns are treated with systemic antibiotics. Concerns have been expressed about the safety of wide use of antibiotics such as antibiotic resistance, emergence of Escherichia coli infections, and long-term side effects due to gut microbiota modifications. New recommendations from the Centers of Disease Control in the United States and from European countries aim at improving GBS detection methods, updating algorithms for GBS intrapartum chemoprophylaxis in pregnant women, defining high-risk newborns more efficiently, and limiting biological evaluation in low-risk newborns.