Study of umbilical cord blood culture in diagnosis of early-onset sepsis among newborns with high-risk factors

Abstract

Context:Blood culture is gold standard for diagnosis of neonatal sepsis. Low sensitivity of blood culture is usually due to small volume of blood sample, intrapartum antibiotics, and antibiotics given to newborn before sampling.Aim:We evaluated use of Umbilical cord blood culture (UCBC) in diagnosis of neonatal sepsis as compared to peripheral venous blood culture.Settings and Design:This study was done in tertiary care teaching hospital during May-June 2012. A total of 45 newborns with presence of two or more risk factors of sepsis were included.Subjects and Methods:Blood sample from placental end of umbilical cord was collected and cultured. Primary outcome was diagnosis of neonatal sepsis by use of umbilical cord blood sample as compared with venous blood sample. Secondary outcome was to compare organisms identified by UCBC and venous blood culture.Statistical Analysis:Sensitivity, specificity, positive and negative predictive values of UCBC were calculated.Results:A total of 24.44% (11 out of 45) high-risk newborns had positive UCBC. A total of 17.8% (8 out of 45) newborns had positive blood culture report. Organisms grown in UCBC were Pseudomonas (45%, 5 out of 11), Acinetobacter (27.27%, 3 out of 11), Escherichia coli (18.18%, 2 out of 11), and Klebsiella (9%, 1 out of 11).Conclusion:UCBC is a good method for diagnosis of neonatal sepsis among high-risk newborns as compared to venous blood culture with a sensitivity of 80% and specificity of 91.43%. Organisms grown are comparable to blood culture samples.

The Bacteriology and Its Virulence Factors in Neonatal Infections: Threats to Child Survival Strategies

“…This study also showed that pathogens were more implicated in peripheral blood than the umbilical cord swab samples. A contrary report was documented by other researchers where the authors discovered that a total of 24.4% high risk newborns had positive lab culture when umbilical cord blood sample was used (11 out of 45) and 8 out of 45 newborn had positive peripheral blood sample culture [ 32 ]. Differences in specimen samples could explain this disparity; whereas the present study also used umbilical cord swab as specimen, Kalathia et al [ 32 ] used only umbilical cord blood as specimen.…”

Clinico-bacteriological profile of neonatal sepsis

“…7 Although blood culture is gold standard for diagnosis of neonatal sepsis, the use of intra-partum antibiotics and empirical antibiotics prior to collecting blood for culture decreases yield of culture. 2,[8][9][10] For choosing the appropriate empirical therapy, one should be aware of the common organisms causing EOS and LOS, so that the antibiotic resistance and emergence of MDR organisms can be reduced. The present study aims to find the common organisms causing neonatal sepsis and their antibiotic sensitivity pattern.…”

Calculator and Prediction Score for Early-onset Neonatal Sepsis in Asymptomatic Term Infant: A Determinant Model

“…Cord blood culture has comparable organism detection to peripheral venous blood culture. 19 The sensitivity of cord blood culture is 80-100% and specificity is 91-94%, while the positive and negative predictive value are 33-72% and 94-100%, respectively. 19,20 It is less invasive and painful, easier to preform, and a larger volume of blood is available compared with peripheal blood cultures.…”