Ferry Liwang, Chindy Arya Sari, Dinarda Ulf Nadobudskaya, Toto Wisnu Hendrarto
OBJECTIVES: To identify the main pathogens of early-onset neonatal sepsis (EONS). METHODS: A search in the 6 electronic databases and manual searches of references from retrieved articles from 2006 – April 2019 was performed using terms relating to “early-onset neonatal sepsis” and “pathogen”. Inclusion criteria were cohort and observational studies that pathogens confirmed by culture, PCR, or other methods. Assessment of risk of bias was conducted using principles from the risk of bias in observational studies of exposures (ROBINS-E) tool. RESULTS: Overall, 19 articles involving 4570 infants with suspected EONS, 51.88% culture-proven EONS. Generally studies were well conducted and had a low risk of bias. In all studies, Gram positive bacteria became the most prevalent agents (58.32%). However, studies in Indonesia and Australia showed the most common cause was Gram negative bacteria.The main pathogens in Gram positive groups was Group B streptococci (GBS) (32%), while in Gram negative was Escherichia Coli (23.83%). Other pathogen in EONS was fungal infection (0.72%). CONCLUSION: As the Gram positive bacteria become the most common pathogen in EONS, antibiotics as the first regimen still relevant. Differences of EONS in continents still could not be concluded due to high heterogenicity of culture and sampling method.