Bacterial pathogens in neonatal sepsis and focal neonatal infections

	Common pathogens*	Some less common pathogens*
Early onset^¶
Term and late preterm infants (GA ≥34 weeks)	GBS E. coli	Enterobacter, Enterococcus, Klebsiella, Listeria, nontypeable H. influenzae, other enteric gram-negative bacilli, S. aureus, viridans streptococci
Preterm infants (GA <34 weeks)	E. coli GBS	CoNS, Enterobacter, Klebsiella, Listeria, other enteric and nonenteric gram-negative bacilli, S. aureus, viridans streptococci
Late onset^¶
Term and late preterm infants (GA ≥34 weeks)	E. coli GBS Additional pathogens seen in the NICU setting – S. aureus, CoNS	Enterobacter, Klebsiella, Listeria, N. meningitidis, other enteric and nonenteric gram-negative bacilli, Salmonella, S. pneumoniae, viridans streptococci Additional pathogens seen in the NICU setting – Citrobacter, Enterococcus, Pseudomonas, Serratia
Preterm infants (GA <34 weeks)	CoNS S. aureus E. coli Klebsiella Enterococcus GBS	Enterobacter, Listeria, Citrobacter, other enteric and nonenteric gram-negative bacilli, Pseudomonas, Salmonella, Serratia, viridans streptococci
Pathogens based on source of infection
Meningitis	GBS E. coli Other gram-negative enteric bacilli	CoNS, Enterococcus, Listeria, N. meningitides, nontypeable H. influenzae, S. aureus, S. pneumoniae, other streptococci (groups A, C, or G and viridans streptococci)
Pneumonia	GBS	C. trachomatis, Citrobacter, Enterobacter, group A Streptococcus, Klebsiella, Pseudomonas, S. aureus, S. pneumoniae, Serratia
Urinary tract infection^Δ	E. coli	Citrobacter, Enterobacter, Enterococcus, Klebsiella, Proteus Additional pathogens seen in the NICU setting – CoNS, S. aureus
Skin and soft tissue infection	S. aureus GBS Group A Streptococcus
Vascular catheter-associated infection	S. aureus CoNS Enterococcus Gram-negatives
Intestinal source/NEC	E. coli Klebsiella Other enteric gram-negative bacilli Clostridium spp Anaerobes (eg, Bacteroides)

GA: gestational age; GBS: group B Streptococcus; E. coli: Escherichia coli; H. influenzae: Haemophilus influenzae; S. aureus: Staphylococcus aureus; CoNS: coagulase-negative staphylococci; NICU: neonatal intensive care unit; N. meningitidis: Neisseria meningitidis; S. pneumoniae: Streptococcus pneumoniae; C. trachomatis: Chlamydia trachomatis; NEC: necrotizing enterocolitis.

* This table summarizes bacterial pathogens in neonatal sepsis and in focal neonatal infections. Common pathogens are listed roughly in order of relative frequency within each category; less common pathogens are listed alphabetically. The list of pathogens within each category is not exhaustive. This table does not address nonbacterial causes of neonatal infections (eg, herpes simplex virus, enterovirus, parechovirus, Candida). Refer to separate UpToDate content for additional information on nonbacterial pathogens.

¶ The definitions of early and late onset vary in different reports. Within UpToDate content, we generally define early onset as <72 hours after birth and late onset as ≥72 hours. However, some experts use <7 days versus ≥7 days, respectively, for these definitions. The definitions of early and late onset as they pertain to GBS disease are somewhat different. Early-onset GBS infection typically presents within 24 hours of birth but can occur through day 6 after birth. Late-onset GBS typically occurs at 4 to 5 weeks of age.

Δ Urinary tract infections may not be associated with bacteremia in neonates.

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Bacterial pathogens in neonatal sepsis and focal neonatal infections