Key points Neonatal ocular prophylaxis for prevention of gonococcal ophthalmia was first introduced by Credé in 1881. Gonococcal ophthalmia became and still is very uncommon due to the introduction in the 1950s of prenatal screening for Neisseria gonorrhoeae and treatment…
Key points The incidence of syphilis in the United States has been increasing since 2012. The two leading causes of missed congenital syphilis prevention opportunities are the lack of adequate maternal syphilis treatment despite a timely diagnosis and absence of…
Key points The incidence of COVID-19 in newborns is low; however, COVID-19 can still cause severe illness and complications. Evidence related to the COVID-19 pandemic and perinatal and neonatal care continues to evolve, but many unanswered questions remain. Pregnant and…
Key points Meningitis occurs most commonly in the neonatal period and is associated with significant morbidity and mortality. Of infants with meningitis, 15% to 38% have negative blood cultures. Selective evaluation of infants with culture-proven bacteremia can result in missed…
Key points Major risk factors for invasive Candida infections include extreme prematurity, a compromised gastrointestinal function or barrier, presence of a central venous catheter, and exposure to broad-spectrum antibiotics, acid suppression medications, and high-dose postnatal steroids. Infants at the highest…
Key points Antibiotics are lifesaving and improve outcomes in neonatal clinical care. Increasing evidence in animal and human models links antibiotic exposure with alterations in the microbiome, the developing immune system, and subsequent effects on health. Empiric antibiotic use is…
Key points Herpes simplex virus (HSV) is a virus that can cause severe infection in a neonate but also has treatment options that can improve disease outcomes. There are three periods of acquisition of HSV: in utero, perinatal, and postnatal.…
Key points Congenital cytomegalovirus (CMV) is the leading infectious cause of hearing loss and neurologic deficits, affecting up to 1% of live births worldwide. Symptomatic congenital CMV infection should be treated with ganciclovir or valganciclovir for 6 months to reduce…
Key points Most early-onset infections in high-resource settings are caused by group B Streptococcus and Escherichia coli. Ampicillin + gentamicin is an appropriate empirical antibiotic regimen for early-onset sepsis in most settings. Most late-onset infections are caused by Gram-positive organisms.…
Key points The current incidence of neonatal early-onset sepsis (EOS) among infants born ≥37 weeks is relatively low (≈1/2000) and as much as 20-fold lower among well-appearing term infants. There are three major approaches to EOS risk assessment among term…