late-onset sepsis
Also written as: LOS — Late-Onset Sepsis
Bacterial bloodstream infection occurring after 72 hours of life, typically acquired from the hospital environment and commonly associated with invasive devices.
Full Definition
Late-onset sepsis (LOS) is defined as bacterial infection of the bloodstream that develops after 72 hours of life, representing a nosocomial (hospital-acquired) infection in most cases. Unlike early-onset sepsis, LOS is typically caused by organisms from the hospital environment, with coagulase-negative Staphylococcus, Staphylococcus aureus, gram-negative bacteria (particularly Escherichia coli and Klebsiella), and occasionally Candida species being the most common pathogens. Risk factors include prematurity, prolonged hospitalization, invasive procedures, central venous catheters, mechanical ventilation, and exposure to broad-spectrum antibiotics. Very low birth weight infants are at highest risk, with rates as high as 20-30%. Clinical presentation may include temperature instability, increased apnea and bradycardia, feeding intolerance, lethargy, and metabolic acidosis. Prompt recognition and treatment are crucial as LOS can lead to significant morbidity including neurodevelopmental impairment and death.
Usage
Usage note: Specify timing (>72 hours) and distinguish from early-onset sepsis; include organism identification when available.
In Context
- "The 28-week infant developed late-onset sepsis with coagulase-negative Staphylococcus on day 14 of life." — Infection documentation
- "Late-onset sepsis rates in the NICU decreased following implementation of central line care bundles." — Quality improvement report