{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:19:28Z","timestamp":1790410768803,"version":"4.1.0"},"reference-count":113,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"publisher","award":["430 064"],"award-info":[{"award-number":["430 064"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"publisher","award":["UMO-2018\/31\/B\/NZ6\/02443"],"award-info":[{"award-number":["UMO-2018\/31\/B\/NZ6\/02443"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The term neonatal sepsis is used to describe a generalized bloodstream infection of bacterial, viral, or fungal origin which is associated with hemodynamic changes and other clinical symptoms and signs, however, there is no unified definition. There are no basic criteria regarding differentiation of early-onset sepsis (EOS) versus late-onset sepsis (LOS). Stratification used in studies on neonatal sepsis also rarely includes the general condition of the newborn according to unambiguous assessment at birth, which hampers the establishment of a clear, uniform epidemiological description of neonatal sepsis. We aim to review the published data about the epidemiology and microbiology of sepsis in Organization for Economic Cooperation and Development (OECD) countries. Data was also collected on sepsis prevention programs that can be implemented in neonatal units. The outcomes of interest were incidence or incidence density of EOS and LOS, microbiology of EOS and LOS, and data on the methodology of the research, in particular the criteria for inclusion and exclusion of newborns from the study. Pubmed, EMBASE, LILACS Embase, Scopus, and Google Scholar were used. For the preselection step, inclusion criteria included: \u201cbloodstream infection\u201d or \u201cneonatal sepsis\u201d (MesH), \u201cvery low birth weight\u201d, and \u201ccountry\u201d full-text studies, human, and English language. Exclusion criteria included: studies published in languages other than English and studies available only as an abstracts. For proper selection, inclusion criteria included: information about epidemiology or microbiology bloodstream infection (BSI), study population and case definitions, exclusion criteria, narrative reviews, commentaries, case studies, pilot studies, study protocols, pediatric studies, and only clinical data (without microbiology or epidemiology) or studies with only one etiological factor analysis. The data review indicated the lack of an unequivocal, unified definition and no unambiguous basic criteria with regard to differentiation of EOS versus LOS. Among infants &lt;1500 g, studies reported an EOS rate from 7% to 2%. For studies using other definitions (mostly all inborn babies), the rate of EOS ranged from 1% to 3%. The LOS incidences were much more varied among countries; the highest rates were in the multicenter studies focused on very low birth weight (VLBW) infants. The main pathogens in EOS are GBS and Gram-negative bacteria in LOS. Our review data shows that LOS microbiology is very diverse and that Gram-positive cocci, especially staphylococci, predominate versus Gram-negative rods. Unfortunately, the lack of uniform, international prevention programs results in high newborn morbidity and insufficient postnatal prevention of late-onset infections.<\/jats:p>","DOI":"10.3390\/jcm8101750","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T11:37:55Z","timestamp":1571657875000},"page":"1750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Neonate Bloodstream Infections in Organization for Economic Cooperation and Development Countries: An Update on Epidemiology and Prevention"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0756-1639","authenticated-orcid":false,"given":"Jadwiga","family":"W\u00f3jkowska-Mach","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Chmielarczyk","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Strus","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryszard","family":"Lauterbach","sequence":"additional","affiliation":[{"name":"Neonatology Clinic, University Hospital, Jagiellonian University Medical College, 31-121 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Heczko","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-121 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"Goldenberg","year":"2008","journal-title":"Lancet"},{"key":"ref_2","first-page":"1","article-title":"Births: Final data for 2007","volume":"58","author":"Martin","year":"2010","journal-title":"Natl. Vital Stat. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1053\/jhin.2002.1341","article-title":"Risk factors for nosocomial infections in a neonatal intensive-care unit","volume":"53","author":"Auriti","year":"2003","journal-title":"J. Hosp. Infect."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/0195-6701(95)90250-3","article-title":"Low birth weight and nosocomial infection of neonates in a neonatal intensive care unit","volume":"30","author":"Drews","year":"1995","journal-title":"J. Hosp. Infect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1542\/peds.103.2.446","article-title":"Causes of Death in the Extremely Low Birth Weight Infant","volume":"103","author":"Barton","year":"1999","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0146-0005(03)00046-6","article-title":"Infections in VLBW infants: Studies from the NICHD Neonatal Research Network","volume":"27","author":"Stoll","year":"2003","journal-title":"Semin. Perinatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1001\/archpedi.155.10.1098","article-title":"Improving survival of vulnerable infants increases neonatal intensive care unit nosocomial infection rate","volume":"155","author":"Zafar","year":"2001","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/oxfordjournals.aje.a113176","article-title":"Nosocomial bloodstream infections in a newborn intensive care unit: A case-matched control study of morbidity, mortality and risk","volume":"114","author":"Townsend","year":"1981","journal-title":"Am. J. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S1473-3099(16)30517-5","article-title":"Health-care-associated infections in neonates, children, and adolescents: An analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey","volume":"17","author":"Zingg","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_10","unstructured":"(2019, July 05). Health at a Glance 2009: OECD Indicators. 1.9. Infant Health: Low Birth Weight. Available online: www.oecd-library.org."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"F248","DOI":"10.1136\/archdischild-2017-314671","article-title":"Australian Study Group for Neonatal Infections: Early-onset neonatal infections in Australia and New Zealand, 2002\u20132012","volume":"104","author":"Singh","year":"2019","journal-title":"Arch. Dis. Child.-Fetal Neonatal Ed."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jhin.2017.11.021","article-title":"Central and peripheral line-associated bloodstream infections in Australian neonatal and paediatric intensive care units: Findings from a comprehensive Victorian surveillance network, 2008\u20132016","volume":"99","author":"Worth","year":"2017","journal-title":"J. Hosp. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1111\/jpc.12863","article-title":"Outcome comparison of very preterm infants cared for in the neonatal intensive care units in Australia and New Zealand and in Canada","volume":"51","author":"Hossain","year":"2015","journal-title":"J. Paediatr. Child Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1111\/j.1651-2227.1998.tb01415.x","article-title":"Septicaemia in an Austrian neonatal intensive care unit: A 7-year analysis","volume":"87","author":"Berger","year":"1998","journal-title":"Acta Paediatr."},{"key":"ref_15","first-page":"943","article-title":"Impact of healthcare-associated sepsis on mortality in critically ill infants","volume":"175","author":"Verstraete","year":"2016","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/apa.13698","article-title":"Management of early-onset neonatal sepsis differs in the north and south of Scandinavia","volume":"106","author":"Drageset","year":"2017","journal-title":"Acta Paediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1111\/j.1651-2227.2009.01322.x","article-title":"Nosocomial infection in a Danish Neonatal Intensive Care Unit: A prospective study","volume":"98","author":"Olsen","year":"2009","journal-title":"Acta Paediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jhin.2013.11.002","article-title":"Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit","volume":"86","author":"Mitt","year":"2014","journal-title":"J. Hosp. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/j.1469-0691.2008.02079.x","article-title":"Nosocomial bloodstream infections in children: An 8-year experience at a tertiary-care hospital in Finland","volume":"14","author":"Sarvikivi","year":"2008","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1365-3016.2010.01132.x","article-title":"Incidence and distribution of pathogens in early-onset neonatal sepsis in the era of antenatal antibiotics","volume":"24","author":"Kuhn","year":"2010","journal-title":"Paediatr. Pe\u0301rinat. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00431-011-1639-7","article-title":"Late-onset neonatal infections: Incidences and pathogens in the era of antenatal antibiotics","volume":"171","author":"Didier","year":"2012","journal-title":"Eur. J. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jhin.2008.01.016","article-title":"Incidence of healthcare-associated infections in high-risk neonates: Results from the Germen surveillance system for very-low-birthweight infants","volume":"68","author":"Geffers","year":"2008","journal-title":"J. Hosp. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1017\/ice.2016.72","article-title":"The Implementation of an Evidence-Based Bundle for Bloodstream Infections in Neonatal Intensive Care Units in Germany: A Controlled Intervention Study to Improve Patient Safety","volume":"37","author":"Salm","year":"2016","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"F293","DOI":"10.1136\/archdischild-2018-315024","article-title":"Epidemiology of infections and antimicrobial use in Greek Neonatal Units","volume":"104","author":"Gkentzi","year":"2018","journal-title":"Arch. Dis. Child.-Fetal Neonatal Ed."},{"key":"ref_25","first-page":"467","article-title":"Neonatal Bacteraemia among 112,360 Live Births","volume":"109","author":"Huggard","year":"2016","journal-title":"Ir. Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1542\/peds.109.1.34","article-title":"Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: A national survey","volume":"109","author":"Makhoul","year":"2002","journal-title":"Pediatrics"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e736","DOI":"10.1542\/peds.2009-2017","article-title":"Outcome of Early-Onset Sepsis in a National Cohort of Very Low Birth Weight Infants","volume":"125","author":"Klinger","year":"2010","journal-title":"Pediatrics"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Bulkowstein, S., Ben-Shimol, S., Givon-Lavi, N., Melamed, R., Shany, E., and Greenberg, D. (2016). Comparison of early onset sepsis and community-acquired late onset sepsis in infants less than 3 months of age. BMC Pediatr., 16.","DOI":"10.1186\/s12887-016-0618-6"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Crivaro, V., Bogdanovi\u0107, L., Bagattini, M., Iula, V.D., Catania, M., Raimondi, F., Triassi, M., and Zarrilli, R. (2015). Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006\u20132010. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-0909-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000337833","article-title":"Culture-Proven Neonatal Sepsis in Japanese Neonatal Care Units in 2006\u20132008","volume":"102","author":"Morioka","year":"2012","journal-title":"Neonatology"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Leal, Y.A., \u00c1lvarez-Nemegyei, J., Vel\u00e1zquez, J.R., Rosado-Quiab, U., Diego-Rodr\u00edguez, N., Paz-Baeza, E., and D\u00e1vila-Vel\u00e1zquez, J. (2012). Risk factors and prognosis for neonatal sepsis in southeastern Mexico: Analysis of a four-year historic cohort follow-up. BMC Pregnancy Childbirth, 12.","DOI":"10.1186\/1471-2393-12-48"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e293","DOI":"10.1111\/apa.12256","article-title":"Incidence and risk factors for catheter-associated bloodstream infections in neonatal intensive care","volume":"102","author":"Yumani","year":"2013","journal-title":"Acta Paediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1016\/S0378-3782(12)70019-1","article-title":"Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units","volume":"88","author":"Hornik","year":"2012","journal-title":"Early Hum. Dev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e262","DOI":"10.1542\/peds.2004-1834","article-title":"Septicemia in the First Week of Life in a Norwegian National Cohort of Extremely Premature Infants","volume":"115","author":"Abrahamsen","year":"2005","journal-title":"Pediatrics"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e269","DOI":"10.1542\/peds.2004-1833","article-title":"Late-Onset Septicemia in a Norwegian National Cohort of Extremely Premature Infants Receiving Very Early Full Human Milk Feeding","volume":"115","author":"Abrahamsen","year":"2005","journal-title":"Pediatrics"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/INF.0b013e3182567b74","article-title":"Early-onset Infections of Very-low-birth-weight Infants in Polish Neonatal Intensive Care Units","volume":"31","author":"Gadzinowski","year":"2012","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"W\u00f3jkowska-Mach, J., Gulczy\u0144ska, E., Nowiczewski, M., Borszewska-Kornacka, M., Doma\u0144ska, J., Merritt, T.A., Helwich, E., Kordek, A., Pawlik, D., and Gadzinowski, J. (2014). Late-onset bloodstream infections of Very-Low-Birth-Weight infants: Data from the Polish Neonatology Surveillance Network in 2009\u20132011. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-339"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1097\/INF.0000000000001958","article-title":"NEOCOSUR Neonatal Network: Late Onset Sepsis in Very Low Birth Weight Infants in the South American NEOCOSUR Network","volume":"37","author":"Escalante","year":"2018","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1442-200X.2008.02685.x","article-title":"Epidemiology of neonatal sepsis in South Korea","volume":"51","author":"Shin","year":"2009","journal-title":"Pediatr. Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1055\/s-0028-1110083","article-title":"Predischarge morbidities in extremely and very low-birth-weight infants in Spanish neonatal units","volume":"26","author":"Moro","year":"2009","journal-title":"Am. J. Perinatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1111\/apa.13104","article-title":"Sepsis as a risk factor for neonatal morbidity in extremely preterm infants","volume":"104","author":"Ohlin","year":"2015","journal-title":"Acta Paediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jpeds.2018.05.048","article-title":"Swiss Pediatric Sepsis Study Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study","volume":"201","author":"Giannoni","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/ped.12218","article-title":"Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7-year period: Coagulase-negative Staphylococcus as the predominant pathogen","volume":"56","author":"Cetinkaya","year":"2014","journal-title":"Pediatr. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"F547","DOI":"10.1136\/archdischild-2017-313203","article-title":"Epidemiology of UK neonatal infections: The neonIN infection surveillance network","volume":"103","author":"Cailes","year":"2018","journal-title":"Arch. Dis. Child.-Fetal Neonatal Ed."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1056\/NEJMoa012657","article-title":"Changes in Pathogens Causing Early-Onset Sepsis in Very-Low-Birth-Weight Infants","volume":"347","author":"Stoll","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/S0140-6736(17)31002-4","article-title":"Neonatal sepsis","volume":"390","author":"Shane","year":"2017","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/PCC.0000000000000157","article-title":"Time for a neonatal-specific consensus definition for sepsis","volume":"15","author":"Wynn","year":"2014","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1099\/jmm.0.002865-0","article-title":"Group B streptococcus colonization of pregnant women and their children observed on obstetric and neonatal wards of the University Hospital in Krakow, Poland","volume":"58","author":"Strus","year":"2009","journal-title":"J. Med. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.micpath.2018.09.014","article-title":"Candida auris: Epidemiology, risk factors, virulence, resistance, and therapeutic options","volume":"125","author":"Sardi","year":"2018","journal-title":"Microb. Pathog."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s13052-018-0515-8","article-title":"Secondary prevention of early-onset sepsis: A less invasive Italian approach for managing neonates at risk","volume":"44","author":"Berardi","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1038\/s41372-018-0081-3","article-title":"What\u2019s the harm? Risks and benefits of evolving rule-out sepsis practices","volume":"38","author":"Hooven","year":"2018","journal-title":"J. Perinatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1111\/apa.14337","article-title":"Antimicrobial stewardship in the neonatal unit reduces antibiotic exposure","volume":"107","author":"McCarthy","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.jpeds.2014.12.023","article-title":"Reappraisal of guidelines for management of neonates with suspected early-onset sepsis","volume":"166","author":"Benitz","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"206","DOI":"10.11124\/jbisrir-2015-1876","article-title":"Routine culture-based screening versus risk-based management for the prevention of early-onset group B streptococcus disease in the neonate: A systematic review","volume":"13","author":"Kurz","year":"2015","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"S143","DOI":"10.1093\/cid\/cix654","article-title":"GBS Intrapartum Antibiotic Investigator Group. Intrapartum Antibiotic Chemoprophylaxis Policies for the Prevention of Group B Streptococcal Disease Worldwide: Systematic Review","volume":"65","author":"Turner","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.wombi.2017.10.012","article-title":"Effectiveness of intrapartum antibiotic prophylaxis for early-onset group B Streptococcal infection: An integrative review","volume":"31","author":"Braye","year":"2018","journal-title":"Women Birth"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Seedat, F., Stinton, C., Patterson, J., Geppert, J., Tan, B., Robinson, E.R., McCarthy, N.D., Uthman, O.A., Freeman, K., and Johnson, S.A. (2017). Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: A systematic review. BMC Pregnancy Childbirth, 17.","DOI":"10.1186\/s12884-017-1432-3"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1038\/pr.2017.111","article-title":"The importance of appropriate initial bacterial colonization of the intestine in newborn, child, and adult health","volume":"82","author":"Walker","year":"2017","journal-title":"Pediatr. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14760584.2016.1209113","article-title":"Group B streptococcal immunisation of pregnant women for the prevention of early and late onset Group B streptococcal infection of the neonate as well as adult disease","volume":"16","author":"Kenchington","year":"2017","journal-title":"Expert Rev. Vaccines"},{"key":"ref_60","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease\u2014Revised guidelines from CDC, 2010","volume":"59","author":"Verani","year":"2010","journal-title":"MMWR Recomm. Rep."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1542\/peds.2012-0541","article-title":"Management of Neonates With Suspected or Proven Early-Onset Bacterial Sepsis","volume":"129","author":"Polin","year":"2012","journal-title":"Pediatrics"},{"key":"ref_62","unstructured":"National Collaborating Centre for Women\u2019s and Children\u2019s Health (UK) (2012). Antibiotics for Early-Onset Neonatal Infection: Anti-Biotics for the Prevention and Treatment of Early-Onset Neonatal Infection."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Wortham, J.M., Hansen, N.I., Schrag, S.J., Hale, E., Van Meurs, K., S\u00e1nchez, P.J., Cantey, J.B., Faix, R., Poindexter, B., and Goldberg, R. (2016). Chorioamnionitis and Culture-Confirmed, Early-Onset Neonatal Infections. Pediatrics, 137.","DOI":"10.1542\/peds.2015-2323"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1001\/jamapediatrics.2016.2836","article-title":"Antibiotic Use and Mortality Among Premature Infants without Confirmed Infection-Perpetrator or Innocent Bystander?","volume":"170","author":"Mukhopadhyay","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1001\/jamapediatrics.2016.2132","article-title":"Association Between Antibiotic Use and Neonatal Mortality and Morbidities in Very Low-Birth-Weight Infants Without Culture-Proven Sepsis or Necrotizing Enterocolitis","volume":"170","author":"Ting","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1093\/jac\/dkx088","article-title":"Antibiotic exposure in neonates and early adverse outcomes: A systematic review and meta-analysis","volume":"72","author":"Esaiassen","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1159\/000455210","article-title":"Bacterial Colonization of the Newborn Gut, Immune Development, and Prevention of Disease","volume":"88","author":"Isolauri","year":"2017","journal-title":"Nestl\u00e9 Nutr. Inst. Workshop Ser."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"F456","DOI":"10.1136\/fetalneonatal-2011-301373","article-title":"Gut microbial colonisation in premature neonates predicts neonatal sepsis","volume":"97","author":"Madan","year":"2012","journal-title":"Arch. Dis. Child.-Fetal Neonatal Ed."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e20182896","DOI":"10.1542\/peds.2018-2896","article-title":"Committee on Infectious Diseases Management of Neonates Born at \u226434 6\/7 Weeks\u2019 Gestation With Suspected or Proven Early-Onset Bacterial Sepsis","volume":"142","author":"Puopolo","year":"2018","journal-title":"Pediatrics"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"325","DOI":"10.3389\/fped.2018.00325","article-title":"Key Components for Antibiotic Dose Optimization of Sepsis in Neonates and Infants","volume":"6","author":"Bielicki","year":"2018","journal-title":"Front. Pediatr."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1007\/PL00014290","article-title":"Corticosteroids and neonatal chronic lung disease","volume":"157","author":"Bancalari","year":"1998","journal-title":"Eur. J. Pediatr."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/00006454-200206000-00006","article-title":"Variations in central venous catheter-related infection risks among Canadian neonatal intensive care units","volume":"21","author":"Chien","year":"2002","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_73","first-page":"544","article-title":"Complications Associated with Central Venous Catheters Inserted in Critically Ill Neonates","volume":"12","author":"Hruszkewycz","year":"1991","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1056\/NEJM199008023230504","article-title":"Association of Intravenous Lipid Emulsion and Coagulase-Negative Staphylococcal Bacteremia in Neonatal Intensive Care Units","volume":"323","author":"Freeman","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_75","first-page":"675","article-title":"Factors Associated With Umbilical Catheter-Related Sepsis in Neonates","volume":"145","author":"Landers","year":"1991","journal-title":"Am. J. Dis. Child."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/00006454-199701000-00005","article-title":"Neonatal airway colonization with Gram-negative bacilli: Association with severity of bronchopulmonary dysplasia","volume":"16","author":"Cordero","year":"1997","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/infdis\/171.3.614","article-title":"Eradication of Endemic Methicillin-Resistant Staphylococcus Aureus Infections from a Neonatal Intensive Care Unit","volume":"171","author":"Haley","year":"1995","journal-title":"J. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1097\/00006454-199711000-00008","article-title":"Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit","volume":"16","author":"Archibald","year":"1997","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1086\/501677","article-title":"Outbreak of Enterobacter cloacae Related to Understaffing, Overcrowding, and Poor Hygiene Practices","volume":"20","author":"Harbarth","year":"1999","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1097\/00006454-199011000-00009","article-title":"A ten-year review of neonatal sepsis and comparison with the previous fifty-year experience","volume":"9","author":"Gladstone","year":"1990","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ajic.2014.11.014","article-title":"National Healthcare Safety Network report, data summary for 2013, Device-associated Module","volume":"43","author":"Dudeck","year":"2015","journal-title":"Am. J. Infect. Control."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijid.2015.04.017","article-title":"Infections and risk-adjusted length of stay and hospital mortality in Polish Neonatology Intensive Care Units","volume":"35","author":"Adamski","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/jp.2009.172","article-title":"A statewide quality improvement collaborative to reduce neonatal central line-associated blood stream infections","volume":"30","author":"Wirtschafter","year":"2010","journal-title":"J. Perinatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.ajic.2010.03.007","article-title":"Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle","volume":"38","author":"Guerin","year":"2010","journal-title":"Am. J. Infect. Control."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1111\/jpc.14078","article-title":"Trends in late-onset sepsis in a neonatal intensive care unit following implementation of infection control bundle: A 15-year audit","volume":"54","author":"Pharande","year":"2018","journal-title":"J. Paediatr. Child Health"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2939","DOI":"10.1099\/00221287-139-12-2939","article-title":"Molecular characterization of the coagulase-negative staphylococcal surface flora of premature neonates","volume":"139","author":"Jaskot","year":"1993","journal-title":"J. Gen. Microbiol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S0022-3476(78)80523-X","article-title":"Bacterial colonization of neonates admitted to an intensive care environment","volume":"93","author":"Goldmann","year":"1978","journal-title":"J. Pediatr."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/0195-6701(88)90209-5","article-title":"The bacterial flora of neonates in intensive care\u2014Monitoring and manipulation","volume":"11","author":"Goldmann","year":"1988","journal-title":"J. Hosp. Infect."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S0022-3476(89)80457-3","article-title":"Surface colonization with coagulase-negative staphylococci in premature neonates","volume":"114","author":"McGowan","year":"1989","journal-title":"J. Pediatr."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/0195-6701(92)90138-C","article-title":"An analysis of the microbial flora of premature neonates","volume":"21","author":"Savey","year":"1992","journal-title":"J. Hosp. Infect."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0195-6701(96)90038-9","article-title":"Nosocomial acquisition of Escherichia coli by infants delivered in hospitals","volume":"32","author":"Fujita","year":"1996","journal-title":"J. Hosp. Infect."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e20153684","DOI":"10.1542\/peds.2015-3684","article-title":"Probiotic Supplementation and Late-Onset Sepsis in Preterm Infants: A Meta-analysis","volume":"137","author":"Rao","year":"2016","journal-title":"Pediatrics"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"e2581","DOI":"10.1097\/MD.0000000000002581","article-title":"Probiotics for Preventing Late-Onset Sepsis in Preterm Neonates: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"95","author":"Zhang","year":"2016","journal-title":"Medicine"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1159\/000441274","article-title":"Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies","volume":"109","author":"Olsen","year":"2016","journal-title":"Neonatology"},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Aceti, A., Maggio, L., Beghetti, I., Gori, D., Barone, G., Callegari, M., Fantini, M., Indrio, F., Meneghin, F., and Morelli, L. (2017). Probiotics Prevent Late-Onset Sepsis in Human Milk-Fed, Very Low Birth Weight Preterm Infants: Systematic Review and Meta-Analysis. Nutrients, 9.","DOI":"10.3390\/nu9080904"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/QCO.0b013e328337fecb","article-title":"Understanding the significance of Staphylococcus epidermidis bacteremia in babies and children","volume":"23","author":"Cheung","year":"2010","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_97","first-page":"206","article-title":"Bacterial translocation and intestinal injury in experimental necrotizing enterocolitis model","volume":"113","author":"Ciftci","year":"2012","journal-title":"Bratisl. Lek. List."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.surge.2012.03.003","article-title":"Gut-origin sepsis: Evolution of a concept","volume":"10","author":"Deitch","year":"2012","journal-title":"Surgeon"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.clnu.2011.09.004","article-title":"Critical systematic review of the level of evidence for routine use of probiotics for reduction of mortality and prevention of necrotizing enterocolitis and sepsis in preterm infants","volume":"31","author":"Mihatsch","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.nut.2018.07.017","article-title":"Probiotic and synbiotic therapy in the critically ill: State of the art","volume":"59","author":"Davison","year":"2018","journal-title":"Nutrition"},{"key":"ref_101","first-page":"CD012519","article-title":"Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants","volume":"12","author":"Grev","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"e11976","DOI":"10.1097\/MD.0000000000011976","article-title":"Prophylactic lactoferrin for preventing late-onset sepsis and necrotizing enterocolitis in preterm infants: A PRISMA-compliant systematic review and meta-analysis","volume":"97","author":"He","year":"2018","journal-title":"Medicine"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"e36521","DOI":"10.7554\/eLife.36521","article-title":"Experimental evaluation of the importance of colonization history in early-life gut microbiota assembly","volume":"7","author":"Kittana","year":"2018","journal-title":"eLife"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.clp.2010.02.002","article-title":"Group B streptococcal disease in infants: Progress in prevention and continued challenges","volume":"37","author":"Verani","year":"2010","journal-title":"Clin. Perinatol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.chom.2018.01.005","article-title":"Commensal Microbes Induce Serum IgA Responses that Protect against Polymicrobial Sepsis","volume":"23","author":"Wilmore","year":"2018","journal-title":"Cell Host Microbe"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S1473-3099(16)00152-3","article-title":"Safety and immunogenicity of an investigational maternal in healthy women and their infants: A randomised phase 1b\/2 trial","volume":"16","author":"Madhi","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.vaccine.2017.01.029","article-title":"Mucosal vaccination promotes clearance of Streptococcus agalactiae vaginal colonization","volume":"35","author":"Baker","year":"2017","journal-title":"Vaccine"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Gupalova, T., Leontieva, G., Kramskaya, T., Grabovskaya, K., Bormotova, E., Korjevski, D., and Suvorov, A. (2018). Development of experimental GBS vaccine for mucosal immunization. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0196564"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/INF.0b013e318275058a","article-title":"Group B Streptococcus and Escherichia coli infections in the intensive care nursery in the era of intrapartum antibiotic prophylaxis","volume":"32","author":"Bauserman","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1038\/s41586-018-0395-5","article-title":"Neonatal selection by Toll-like receptor 5 influences long-term gut microbiota composition","volume":"560","author":"Fulde","year":"2018","journal-title":"Nature"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.mib.2017.11.030","article-title":"Evolution of virulence in Enterococcus faecium, a hospital-adapted opportunistic pathogen","volume":"41","author":"Gao","year":"2018","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/infdis\/jiv429","article-title":"Extraintestinal Pathogenic Escherichia coli, a Common Human Pathogen: Challenges for Vaccine Development and Progress in the Field","volume":"213","author":"Poolman","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_113","unstructured":"Higgins, J.P.T., and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011], Cochrane Collaboration. Available online: www.cochrane-handbook.org."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/10\/1750\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:28:12Z","timestamp":1760189292000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/10\/1750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,21]]},"references-count":113,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10]]}},"alternative-id":["jcm8101750"],"URL":"https:\/\/doi.org\/10.3390\/jcm8101750","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,21]]}}}