Neonatal Late-Onset Sepsis Identification

Because there is no consensus definition for neonatal sepsis,^{11 (link)} we considered a new bacteremic or fungemic event in an infant aged greater than 72 hours who received 5 or more days of antibiotic treatment or died before completing at least 5 days of treatment with intention to treat as a late-onset infection (LOI) episode. The onset of the LOI episode was defined as the time of clinician declaration of suspected infection, herein defined as the time of blood culture acquisition. Late-onset episodes of surgical peritonitis (perforated bowel associated with necrotizing enterocolitis or spontaneous intestinal perforation) with negative results of blood cultures were included as an irrefutable source of infection. Infants with positive blood cultures with organisms that are frequently considered contaminants, including Bacillus species and Corynebacterium species, were excluded.