EVALUATION OF SURFACE CULTURES IN PREDICTING NEONATAL SEPSIS

Abstract

Bacterial infections continue to be a major problem in neonatal intesnsive care units (NICUs). In an effort to anticipate septic events and guide antimicrobial therapy, many NICUs attempt to identify potential pathogens before infections occur by routinely culturing a variety of surface body sites. This practice is based on the concept that colonization of the infant precedes infection and that identification of potential pathogens in the colonizing surface flora is predictive of those that 'later cause invasive disease.

This study was carried out on 70 neonates who were admitted to NICUs at Assiut University Hospital. All our cases were subjected to full menticulous history taking, thorough physical examination and the following investigations were done: complete blood count, surface cultures and blood cultures were done only for neonates that suspected to develop sepSIS.

All cases were subjected to close observation and follow up for the development of neonatal sepsis. It was observed that cases who developed neonatal sepsis showed significantly lower levels of gestational age, birth weight and platelet counts and higher levels of immature to total neutrophil ratio but they did not show any significant difference for both white blood cell counts and polymorphonuclear lenkoc)1ic counts.

For site-specific analysis, the highest sensitivity and specificity were associated with swabs from umbilicus and ear also the highest positive predictive value was associated with swabs from the umbilicus.