This category includes infants with 1 of
the risk factors for sepsis noted previously
(colonization with GBS, prolonged
rupture of membranes >18 hours, or
maternal chorioamnionitis). GBS is not
a risk factor if the mother has received
adequate intrapartum therapy (penicillin,
ampicillin, or cefazolin for at least
4 hours before delivery) or has a cesarean
delivery with intact membranes
in the absence of labor.93 The risk of
infection in the newborn infant varies
considerably with the risk factor present.
The greatest risk of early-onset
sepsis occurs in infants born to women
with chorioamnionitis who are also
colonized with GBS and did not receive
intrapartum antimicrobial agents. Earlyonset
sepsis does occur in infants who
appear healthy at birth.21 Therefore