Late-onset sepsis (LOS) incidence in very preterm infants (VPIs) decreased significantly from 2010 to 2017 but has increased from 2018 to 2023.
The rising trend from 2018 onward is mainly driven by non-coagulase-negative staphylococci (non-CoNS) gram-positive bacteria and gram-negative bacteria, particularly Staphylococcus aureus and Klebsiella species.
Coagulase-negative staphylococci remain the most frequent pathogens overall, but their incidence has not driven recent increases.
LOS remains associated with high mortality (15.4%) in VPIs, emphasizing the ongoing need for targeted surveillance and prevention strategies.
