👶 Neonatal Early-Onset Sepsis Risk (Kaiser EOS Framework)
The Kaiser Permanente early-onset sepsis (EOS) framework combines perinatal risk factors with the infant's clinical examination to stratify management in newborns ≥ 34–35 weeks.
Neonatal Early-Onset Sepsis Risk (Kaiser EOS Framework)
Gestational age at birth (applies to ≥ 34–35 wk) (wk)
Maximum maternal intrapartum temperature (°C)
Duration of rupture of membranes (h)
Maternal GBS status
Intrapartum antibiotics
Neonatal clinical grade
When to use
Use in well-appearing-to-ill newborns ≥ 34–35 weeks to decide between routine care, enhanced observation, and blood culture plus empiric antibiotics.
How it works
Birth risk derives from GA, maximum maternal intrapartum temperature, ROM duration, GBS and intrapartum antibiotics; combined with clinical grade — risk < 1/1000 routine, 1–3 enhanced observation ± culture, > 3 culture + antibiotics; clinical illness → culture + antibiotics regardless of risk.
Key points
- It replaces a subjective chorioamnionitis diagnosis with objective inputs (maximum maternal temperature, ROM duration), reducing unnecessary antibiotic exposure in well infants.
- Clinical illness mandates blood culture plus empiric antibiotics regardless of the calculated risk; equivocal exam adds culture plus enhanced observation.
- The exact quantitative risk per 1000 live births requires the official online calculator; this framework does not substitute a specific risk number.
References
- Kuzniewicz MW, et al. A quantitative, risk-based approach to early-onset sepsis. JAMA Pediatr 2017.
- Kaiser Permanente Neonatal Early-Onset Sepsis Calculator.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.