Efficacy of Umbilical Cord and Peripheral Venous Blood Cultures in Diagnosing Sepsis in High-Risk Neonates

Seeta Mutalik, Sahana Devadas, Raju Ravikumar

Abstract

Background and Aim: Sepsis is a major cause of mortality and morbidity in neonates. Although peripheral venous blood culture is the gold standard for the diagnosis of early-onset sepsis (EOS), the accuracy of diagnosis is limited by low sensitivity usually due to small volume of blood sample, use of intrapartum antibiotics, and antibiotics administered to neonates before sampling. 

The aim of this study was to evaluate the efficacy of umbilical cord blood culture (UCBC) and peripheral venous blood culture (PVBC) in diagnosing EOS in high-risk neonates.

Materials and Methods: This study included 60 preterm neonates who were at a high risk of developing EOS. Immediately after delivery, umbilical cord and peripheral venous blood samples were collected. Blood samples were inoculated on culture media and incubated. Subcultures were made from the positive vials and microbial detection was done using the BacT/ALERT system on MacConkey and blood agar plates. The isolated microorganisms were identified and an antibiogram was generated using the VITEK 2C system. The sensitivity, specificity, positive predictive value, and negative predictive value of UCBC and PVBC were compared.

Results: Among the 60 high-risk neonates, 41.66% developed clinical EOS. Of these, 84% neonates tested positive on UCBC and 64% neonates tested positive on PVBC. The sensitivity and specificity of UCBC were 84% and 94.2% and that of PVBC were 64% and 100%, respectively.

Conclusions: UCBC is superior to PVBC in diagnosing EOS in preterm neonates with perinatal risk factors for sepsis.

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