<p>Rapid diagnosis of neonatal sepsis by PCR for detection of 16S rRNA gene, while blood culture and PCR results were similar in <em>E.coli</em>-predominant EOS cases</p>

Abstract

Purpose To determine the bacteriological pattern and antibiotic susceptibility of bacterial isolates causing neonatal sepsis in Qena University Hospitals and compare polymerase chain reaction (PCR) and blood culture results in a trial for rapid diagnosis. Patients and methods Blood samples from 75 clinically suspected cases of neonatal sepsis were subjected to identification of bacteria and determination of their antibiotic sensitivity through blood culture, and rapid detection of 16S rRNA and the uidA gene (to confirm the presence of E. coli ) by PCR from extracted bacterial DNA. Results Most patients were preterm (64%) and low birth weight (LBW) (68%). In total, 42.7% presented with early onset sepsis (EOS). LBW was significantly associated with EOS ( P -value=0.03). Although the blood culture and PCR results were similar in EOS, the PCR results were significantly higher than those of blood culture in detecting bacteria (85.3% vs 68%, respectively, P -value=0.001). Blood culture showed 100% specificity. The most common pathogen was E. coli (86.2%) in EOS and Staphylococcus spp . (45.5%) in late-onset sepsis (LOS) ( P -value=0.001 and 0.02, respectively). The most effective antibiotics against Gram-negative bacteria were ofloxacin, ciprofloxacin, imipenem, and amikacin, while vancomycin, oxacillin, and imipenem were the most effective antibiotics against Gram-positive bacteria. Conclusion EOS was mainly caused by E. coli , while LOS was mainly caused by Staphylococcus spp . The 16S rRNA PCR showed higher sensitivity with rapid and accurate diagnosis. Blood culture is the most suitable method for antimicrobial sensitivity testing.

Automated Blood Culture versus Amplification of 16S rRNA Gene Method for Detection of Neonatal Septicemia

“…In our study, neonatal sepsis was predominant in males (57.5 %) which is comparable to that observed in other studies carried by Kung et al 18 ; Hammoud et al 19 and EL-Amir et al 15 who found that males represent 52.8, 54.9% and 53.3% respectively. None of the previous studies found a significant difference between males and females in neonatal sepsis, which is similar to the present results.…”

“…Anwar et al 21 reported that neonatal sepsis was diagnosed in 53.8% of their neonates delivered also by C.S. Nehal et al 22 and EL-Amir et al 15 showed that neonatal sepsis occurs more frequently in neonates delivered by normal vaginal delivery with percentage of 70% and 65.3% respectively.…”

“…Perera et al 12 found that mothers of 15% of sick, term neonates had PROM lasting 18 hours or more. Also, EL-Amir et al 15 reported that about onethird of their patients were exposed to PROM. Stoll.…”

The Accuracy of 16S rRNA Polymerase Chain Reaction for the Diagnosis of Neonatal Sepsis: A Meta‐Analysis

“…Upon title and abstract review, 1368 studies were excluded, and 119 were subjected to full-text review. Of these, 100 were excluded because valid data could not be extracted, and the remaining 19 articles were included in our study [12,13,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] (Figure 1).…”

“…All studies used a prospective study design to avoid inappropriate exclusion (Figure 2). Five studies did not specify whether patients were continuously enrolled or not [25,26,[28][29][30]. The remaining studies specified continuous enrollment.…”