One page summary: Neonatal sepsis and Group B strep

In two sentences

Neonatal sepsis is the body's dangerous whole-system response to infection in a newborn. It can move from a baby who seems slightly off to a baby who is critically unwell within hours. ¹

The most common single cause of early newborn infection has been Group B strep, a bacteria that lives harmlessly in many adults. Screening in pregnancy and antibiotics during labor for those who test positive are the reason early-onset GBS disease has fallen sharply. ^{1 2}

The numbers, with their sources

• The prevention standard. Screening for Group B strep in late pregnancy and giving antibiotics through a vein during labor to those who screen positive or who have risk factors ¹
• Timing matters. Antibiotics in labor work best when given with enough time before delivery, which is why the time the first dose was given is recorded ¹
• Two timings of infection. Early-onset sepsis appears in the first days and usually comes from bacteria encountered around birth. Late-onset appears afterward and often comes from the environment ¹
• National surveillance. CDC tracks invasive Group B strep disease through Active Bacterial Core surveillance and publishes reports on it ²
• The signs are vague. Temperature instability, poor feeding, sleepiness, fast breathing and irritability. There is no single sign, which is why any newborn who seems off is evaluated ¹
• The rule that saves lives. Antibiotics are started before results come back. Waiting for cultures in a newborn who looks unwell is not standard care ¹

What to do this week

1. Ask what the GBS screening result was and when it was taken.
2. Ask whether antibiotics were given in labor, which one, and at what time the first dose went in.
3. Ask what risk factors were present: fever in labor, prolonged rupture of membranes, preterm labor.
4. Ask whether a lumbar puncture was done and what it showed.
5. Ask what organism grew, if any, and how long the antibiotic course is.
6. Ask for a hearing assessment if meningitis was present or suspected.
7. Request the labor records with the records request builder.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the neonatologist

• What organism is suspected or confirmed?
• Was a lumbar puncture done, and what did it show?
• How long is the antibiotic course, and what decides that?
• Was there a period of low blood pressure or low oxygen?
• What follow-up do we need, including hearing?

For the obstetric team

• What was my GBS screening result, and when was it done?
• Were antibiotics given in labor, which one, and at what time?
• Did I have a fever in labor, and how long were my membranes ruptured?
• Was chorioamnionitis diagnosed?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Neonatal sepsis and Group B strep

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.