Study of Umbilical Cord Blood Culture in diagnosis of early-onset sepsis among newborns with high-risk factors.

Abstract

Introduction: 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 March 2016-December 2016. A total of 55 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, specifi city, positive and negative predictive values of UCBC were calculated. Results : A total of 38.1% (21 out of 55) high-risk newborns had positive UCBC. A total of 32.7% (18 out of 55) newborns had positive blood culture report. Organisms grown in UCBC were Pseudomonas (45%, 9 out of 21), Acinetobacter (27.27%, 6 out of 21), Escherichia coli (18.18%, 4 out of 21), and Klebsiella (9%, 2 out of 21). 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 specifi city of 91.43%. Organisms grown are comparable to blood culture samples.