Umbilical Cord Blood Culture in Diagnosis of Early Onset Neonatal Sepsis
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ORIGINAL ARTICLE
Umbilical Cord Blood Culture in Diagnosis of Early Onset Neonatal Sepsis Ramraj Meena 1 & Kailash Kumar Meena 1 & Vivek Athwani 1 & Sunil Gothwal 1 & Ghan Shyam Bairwa 2 & Sadasivam Sitaraman 1 Received: 21 February 2020 / Accepted: 11 May 2020 # Dr. K C Chaudhuri Foundation 2020
Abstract Objective To evaluate the use of umbilical cord blood culture (UCBC) as compared to neonatal blood culture (NBC) in the diagnosis of early onset neonatal sepsis (EONS). Methods This hospital based prospective observational study was conducted in the Department of Pediatrics and Department of Obstetrics & Gynaecology at a tertiary care centre of North India from 2017 through 2018. A total of 80 newborns with presence of two or more risk factors for sepsis were included in the study. Blood culture samples were collected from the umbilical cord at delivery and from the neonate within 1 h of birth. Results UCBC was positive in 17 (21.2%) neonates and NBC was positive in 15 (18.7%) neonates. Out of these positive cases, 10 (45.4%) neonates had similar bacteriological profile in both UCBC and NBC which included Burkholderia cepacia, Acinetobacter species, Enterobacter cloacae and Coagulase-negative Staphylococcus. UCBC had a sensitivity of 66.7%, a specificity of 89.2%, a positive predictive value 58.8% and a negative predictive value 92.1% for the diagnosis of EONS in high risk neonates, considering NBC as the gold standard test. Conclusions UCBC is a reliable alternative to NBC for early etiological diagnosis of EONS in high risk neonates. Additional blood sampling from the newborn is suggested if there is any clinical sign of sepsis. Keywords Neonate . Blood culture . Sepsis
Introduction Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. Early onset neonatal sepsis (EONS) presents within the first 72 h of life and the source of infection is generally the maternal genital tract. Neonatal sepsis is the most common cause of neonatal morbidity and mortality in developing countries [1]. Early appropriate diagnosis followed by prompt treatment is necessary to improve the survival without morbidity. Neonatal sepsis is clinically diagnosed by a combination of clinical signs and
* Sunil Gothwal [email protected] 1
Department of Pediatrics, SMS Medical College and J K Lon Hospital, Jaipur, Rajasthan, India
2
Department of Pediatrics, Jaipuria Hospital and RUHS, Jaipur, Rajasthan, India
specific laboratory tests. Unfortunately, clinical signs are subtle and non-specific and can easily be confused with other non-infective causes; so diagnosis of early onset neonatal sepsis remains a challenge for neonatal healthcare providers [2]. Although laboratory markers of sepsis complement the diagnosis, demonstration of organism from patient’s blood remains the gold standard for diagnosing neonatal sepsis [3]. Yield of blood culture is affected by many factors, blood volume being the most important factor [4]. It is a r
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