A 2-day-old neonate develops poor feeding, temperature instability, and pallor. Blood culture is obtained and empirical antibiotic therapy for early-onset neonatal sepsis (EOS) should cover which organisms primarily?

• A Group B Streptococcus and E. coli — the two most common pathogens of EOS ✓
• B Staphylococcus epidermidis and Klebsiella
• C Listeria monocytogenes and Candida albicans
• D Pseudomonas aeruginosa and MRSA

Explanation

Early-onset neonatal sepsis (within 72 hours of birth) is predominantly caused by Group B Streptococcus (GBS) and Gram-negative enteric organisms, especially E. coli. These colonize the infant via vertical transmission from the birth canal. The empirical regimen of ampicillin plus gentamicin specifically targets these two groups. Coagulase-negative staphylococci and Klebsiella are more relevant in late-onset (nosocomial) sepsis.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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