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Review
. 2025 Mar;52(1):33-45.
doi: 10.1016/j.clp.2024.10.003. Epub 2024 Nov 27.

Late-Onset Sepsis: Epidemiology, Microbiology, and Controversies in Practice

Jessica E Ericson  1 , Alexander G Agthe  2 , Joern-Hendrik Weitkamp  2
Affiliations
Review

Late-Onset Sepsis: Epidemiology, Microbiology, and Controversies in Practice

Jessica E Ericson et al. Clin Perinatol. 2025 Mar.

Abstract

Late-onset sepsis (LOS) is a common cause of neonatal morbidity and mortality. Causative pathogens vary by gestational age and geographic location. Preterm neonates in low-resource settings are at greatest risk and the majority of cases are due to gram-negative pathogens, especially Escherichia coli and Klebsiella species. Neonates in high-resource settings are more frequently infected with gram-positive organisms such as coagulase-negative Staphylococci and Staphylococcus aureus. Viruses, fungi, and parasites can also cause LOS and should be considered if bacterial cultures are sterile.

Keywords: Bacteremia; Coagulase-negative staphylococci; Empirical antibiotics; Meningitis.

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Conflict of interest statement

Disclosure Dr J-H. Weitkamp has been a paid consultant for Roche Diagnostics, Inc for the development of IL-6 as a neonatal sepsis biomarker. All other authors have no conflicts to disclose.