{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:41:35Z","timestamp":1791027695645,"version":"4.1.0"},"reference-count":50,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,8,1]]},"abstract":"<jats:sec><jats:title>Background.<\/jats:title><jats:p>Few data are available on the outcome of neonatal sepsis evaluations in an era when intrapartum antibiotic therapy is common.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We identified all newborns weighing \u22652000 g at birth who were ever evaluated for suspected bacterial infection at 6 Kaiser Permanente hospitals between October 1995 and November 1996, reviewed their records and laboratory data, and tracked them to 1 week after discharge. We analyzed the relationship between key predictors and the presence of neonatal bacterial infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Among 18\u2009299 newborns \u22652000 g without major congenital anomalies, 2785 (15.2%) were evaluated for sepsis with a complete blood count and\/or blood culture. A total of 62 (2.2%) met criteria for proven, probable, or possible bacterial infection: 22 (.8%) had positive cultures and 40 (1.4%) had clinical evidence of bacterial infection. We tracked all but 10 infants (.4%) to 7 days postdischarge. There were 67 rehospitalizations (2.4%; 2 for group B streptococcus bacteremia). Among 1568 infants who did not receive intrapartum antibiotics, initial asymptomatic status was associated with decreased risk of infection (adjusted odds ratio [AOR]: .26; 95% confidence interval [CI]: .11\u2013.63), while chorioamnionitis (AOR: 2.40; 95% CI: 1.15\u20135.00), low absolute neutrophil count (AOR: 2.84; 95% CI: 1.50\u20135.38), and meconium-stained amniotic fluid (AOR: 2.23; 95% CI: 1.18\u20134.21) were associated with increased risk. Results were similar among 1217 infants who were treated, except that maternal chorioamnionitis was not significantly associated with neonatal infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>The risk of bacterial infection in asymptomatic newborns is low. Evidence-based observation and treatment protocols could be defined based on a limited set of predictors: maternal fever, chorioamnionitis, initial neonatal examination, and absolute neutrophil count. Many missed opportunities for treating mothers and infants exist.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.106.2.256","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"256-263","source":"Crossref","is-referenced-by-count":175,"title":["Neonatal Sepsis Workups in Infants \u22652000 Grams at Birth: A Population-Based Study"],"prefix":"10.1542","volume":"106","author":[{"given":"Gabriel J.","family":"Escobar","sequence":"first","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"},{"name":"Department of Pediatrics, Kaiser Permanente Medical Center, 1425 S Main St, Walnut Creek, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De-kun","family":"Li","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Anne","family":"Armstrong","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla N.","family":"Gardner","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce F.","family":"Folck","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan E.","family":"Verdi","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blong","family":"Xiong","sequence":"additional","affiliation":[{"name":"From Kaiser Permanente Medical Care Program, Division of Research, Perinatal Research Unit, Oakland, California; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Bergen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kaiser Permanente Medical Center, 1425 S Main St, Walnut Creek, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Neonatal Infection Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,8,1]]},"reference":[{"key":"2021121003185436900_B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0045-9380(77)80005-4","article-title":"Pathogenesis and management of neonatal sepsis and meningitis.","volume":"8","author":"Wientzen","year":"1977","journal-title":"Curr Probl Pediatr"},{"key":"2021121003185436900_B2","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1056\/NEJM198103123041105","article-title":"Sepsis neonatorum.","volume":"304","author":"Siegel","year":"1981","journal-title":"N Engl J Med"},{"key":"2021121003185436900_B3","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1056\/NEJM197706022962206","article-title":"Patterns of use of antibiotics in two newborn nurseries.","volume":"296","author":"Hammerschlag","year":"1977","journal-title":"N Engl J Med"},{"key":"2021121003185436900_B4","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1542\/peds.64.5.573","article-title":"Use of antimicrobial drugs in general hospitals. 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