Umbilical cord blood culture versus peripheral venous blood culture in early onset neonatal sepsis
Keywords:Neonatal sepsis, Peripheral vein blood culture, Sepsis Screen, Umbilical cord blood culture
Background: Neonatal sepsis is a major cause of neonatal morbidity and mortality. Blood culture and sensitivity is gold standard for the diagnosis of neonatal sepsis. Low sensitivity of blood culture especially in newborn is due to small volume of blood sample collected from neonates and antibiotics given before sampling. The aim was to evaluate the use of umbilical cord blood culture in the diagnosis of early onset neonatal sepsis as compared to Peripheral vein blood culture.
Methods: Eighty neonates with two or more risk factors for early onset neonatal sepsis were included in the study. Blood samples were collected from umbilical cord and peripheral vein for culture. Sepsis screen was done to corroborate the diagnosis of neonatal sepsis.
Results: Sepsis screen was positive in twenty three babies. Among these four had grown organism on Umbilical cord blood culture only. While two babies had both positive, Umbilical cord bloods culture and peripheral vein blood culture. Organisms grown on culture were E.Coli, Pseudomonas, Klebsiella and Acinetobacter.
Conclusions: Umbilical cord blood culture is simple and convenient method for the diagnosis of early onset neonatal sepsis compared to peripheral venous blood culture. Organisms grown are comparable to peripheral venous blood culture sample.
Qazi SA, Stoll BJ. Neonatal sepsis: a major global public health challenge. Pediatr Infect Dis J. 2009;28:1-2.
Barbara J, Stoll, Shane AL. Nelson textbook of paediatrics. 20th edition. Infection of the Neonatal Infant. 1999;909.
Liu L, Johnson HL, Cousens S. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.
Stoll BJ, Hansen NI, Sanchez PJ. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatr. 2011;127:817-26.
Dutta S, Kadam S, Saini SS. Management of neonatal sepsis. evidenced based clinical practice guidelines. National Neonatology Forum of India. 2010:155-72.
Investigators of national neonatal perinatal database. Available at http:// www. newbornwhocc.org /pdf /nnpdreport 2002-03.PDF. Last accessed on 10 May 2013.
Polin JI, Knox I, Baumgart S. Use of umbilical cord blood culture for detection of neonatal bacteremia. Obstet Gynecol. 1981;57(2):233-7.
Neal PR, Kleiman MB, Reynolds JK. Volume of blood submitted for culture from neonates. J Clin Microbiol. 1986;24:353-6.
Brown DR, Kutler D, Rai B. Bacterial concentration and blood volume required for a positive blood culture. J Perinatol. 1995;15:157-9.
Committee on fetus and newborn. Available at http://pediatrics.aappublications.org/content/129/5/1006.full.html. Accessed on 10 May 2013.
Pryles CV, Steg LN, Nair S, Gellis SS, Tenney B. A controlled study of the influence on the newborn of prolonged premature rupture of the amniotic membranes and/or infection in the mother. Pediatrics. 1963;31:608-22.
Tyler CW, Albers WH. Obstetric factors related to bacteremia in the newborn infant. Am J Obstet Gynecol. 1966;94:970-6.
Polin JI, Knox I, Baumgart S, Campman E, Mennuti MT, Polin RA. Use of umbilical cord blood culture for detection of neonatal bacteremia. Obstet Gynecol. 1981;57:233-7.
Herson VC, Block C, Mclaughlin JC, Tetreault J, Eisenfeld LI, Krause PJ. Placental blood sampling: An aid to the diagnosis of neonatal sepsis. J Perinatol. 1998;18:135-7.
Hansen A, Forbes P, Buck R. Potential substitution of cord blood for infant blood in neonatal sepsis evaluation. Biol Neonate. 2005;88:12-8.
Chawla D, Agarwal R. Rational approach to diagnosis of neonatal sepsis. J Neonatol. 2006;20:4-7.
Misra R, Jadhav S, Ghosh P. Role of sepsis screen in the diagnosis of neonatal sepsis. Med JDY Patil Univ. 2013;6:254-7.
Jiang JH, Chiu NC, Huang FY. Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbiol Immunol Infect. 2004;37:301-6.
Costakos DT, Walden J, Rinzel MT, Dahlen L. Painless blood testing to prevent neonatal sepsis. WMJ. 2009;108:321-2.
Fos NI, Gomis RV, Gomis CV, Rubio J, Justich P, Valera JC, et al. Blood culture from the umbilical vein in the diagnosis of neonatal sepsis. Internet J Pediatr Neonatol. 2010;12:1.
Deorari A. Investigators of National neonatal perinatal database (NNPD) Changing pattern of bacteriologic profile in neonatal sepsis among intramural babies. J Neonatol. 2006;20:1.
Bhat YR, Lewis LE, Vandana KE. Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: An audit from a center in India. Ital J Pediatr. 2011;37:32.
Kalathia MB, Shingala PA, Parmar PN. Study of umbilical cord blood culture in diagnosis of early-onset sepsis among newborns with high-risk factors. J Clin Neonatol. 2013;2:169-72.