Blood Culture From The Umbilical Vein In The Diagnosis Of Neonatal Sepsis.

Abstract

Background: Sepsis is a significant cause of mortality and morbidity in Neonatology Departments. Frequently neonatologists use the presence of a positive blood culture to confirm diagnosis and then they undergo lumbar puncture. Positive blood cultures are the gold standard and are used to predict neonatal outcome and determine type of antibiotics combination ant length of treatment. Objective: The aim of this study was to obtain blood culture from umbilical vein in newborns with infection risk factors and seeing if its culture is more sensible for isolating micro-organisms. Design: A prospective study of 784 deliveries with 45 infection risk factors newborns Patients: We select a cohort of newborns with perinatal infection risk factors during 3 months. Clinical data for these neonates were recorded prospectively and in the delivery room a blood sample from the umbilical vein was culture. These neonates were followed during almost the firsts 72 hours of live and clinical and laboratory test was made. Results. We obtained a total sample size in this study of 30 blood cultures. From this sample blood culture was positive in 13 (43%) and negative in 17 (57%). Of the 13 positive blood cultures 7 (54%) neonates presents clinical and laboratory findings and sepsis diagnosis was made, 3 (23%) were considered contaminants and 3 (23%) were bacteraemies. In all neonates serial RBC, leukocyte counts and CRP were made and in newborns with positive blood culture a new blood sample for culture and CSF culture was performed. Conclusions: Diagnosis of neonatal sepsis by positive blood culture in clinical practice is difficulted by maternal antibiotic prophylaxis and blood sample size. Various diagnostics approaches are necessary to make diagnosis and to determine the length of therapy. Umbilical vein samples represented a new and more sensible way to diagnostics early neonatal sepsis.