1887

Abstract

Summary

The results of body fluid and surface cultures from 148 preterm infants 33 weeks gestational age obtained routinely on admission to a neonatal intensive care unit were reviewed. The aim was to determine the occurrence of congenital bacterial sepsis in this population and to examine whether surface cultures yielded information helpful in management. Gastric aspirate and umbilical, nasal and ear swabs were cultured and the results were compared to those of blood cultures. Nine infants (5.4%) had congenital bacterial sepsis diagnosed by positive blood cultures. Only the results of microscopy of gastric aspirate were available within hours of birth and before the results of blood culture. Microscopy of gastric aspirate, demonstrating pus cells, alone had a sensitivity of 0.86 in predicting congenital sepsis but a specificity of 0.49; the specificity, however, rose to 0.80 if both organisms and pus cells were observed on microscopy. Thus, only this combination was a useful pre-indicator of congenital sepsis. In infants who did not develop septicaemia, treatment was modified only if was cultured from surface sites; in all such cases, the organism was grown from the ear swab. Our results demonstrate that congenital bacterial sepsis is common amongst very preterm infants admitted for neonatal intensive care but routine screening of surface cultures should be restricted to an ear swab only.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-36-2-117
1992-02-01
2024-04-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/36/2/medmicro-36-2-117.html?itemId=/content/journal/jmm/10.1099/00222615-36-2-117&mimeType=html&fmt=ahah

References

  1. Morales W. J., Angel J. L., O’Brien W. F., Knuppel R. A., Finazzo M. A randomized study of antibiotic therapy in idiopathic preterm labor. Obstet Gynecol 1988; 72:829–833
    [Google Scholar]
  2. Mims L. C., Medawar M. S., Perkins J. R., Grubb W. R. Predicting neonatal infections by evaluation of the gastric aspirate: a study in two hundred and seven patients. Am J Obstet Gynecol 1972; 114:232–238
    [Google Scholar]
  3. Ablow R. C., Driscoll S. G., Effmann E. L., Gross J. A comparison of early-onset group B streptococcal neonatal infection and the respiratory-distress syndrome of the newborn. N Engl J Med 1976; 294:65–70
    [Google Scholar]
  4. Pyati S. P., Pildes R. S., Ramamurthy R. S., Jacobs N. Decreasing mortality in neonates with early-onset group B streptococcal infection: reality or artefact. J Pediatr 1981; 98:625–627
    [Google Scholar]
  5. Schmidt M., Bors Z. Kis, É., Bacterial colonization of newborn infants in an intensive care unit. Acta Microbiol Hung 1983; 30:259–262
    [Google Scholar]
  6. Thorner R. M., Remein Q. R. Principles and procedures in the evaluation of screening for disease. US Public Health Service, Division of Chronic Diseases Washington DC: Government Printing Office; 1961 Monograph no 6724 pp
    [Google Scholar]
  7. Wientzen R. L., McCracken G. H. Pathogenesis and management of neonatal sepsis and meningitis. Current Problems in Pediatrics 1977 VIII Dec
    [Google Scholar]
  8. Boyle R. J., Chandler B. D., Stonestreet B. S., Oh W. Early identification of sepsis in infants with respiratory distress. Pediatrics 1978; 62:744–750
    [Google Scholar]
  9. Overall J. C. Neonatal bacterial meningitis. J Pediatr 1970; 76:499–511
    [Google Scholar]
  10. Evans E. M., Schaffner W., Federspiel C. F., Cotton R. B., McKee K. T., Stratton C. W. Sensitivity, specificity, and predictive value of body surface cultures in a neonatal intensive care unit. JAMA 1988; 259:248–252
    [Google Scholar]
  11. Pacifico L., Chiesa C., Cianfrano V., Panero A., Bucci G., Midulla M. Body surface cultures in the neonatal intensive care unit. JAMA 1989; 261:46
    [Google Scholar]
  12. Maudsley R. F., Brix G. A., Hinton N. A., Robertson E. M., Bryans A. M., Haust M. D. Placental inflammation and infection. Am J Obstet Gynecol 1966; 95:648–659
    [Google Scholar]
  13. Pole G., McAllister T. A. Gastric aspirate analysis in the newborn. Acta Paediatr Scand 1975; 64:109–112
    [Google Scholar]
  14. Scanlon J. The early detection of neonatal sepsis by examination of liquid obtained from the external ear canal. J Pediatr 1971; 79:247–249
    [Google Scholar]
  15. MacGregor R. R., Tunnessen W. W. The incidence of pathogenic organisms in the normal flora of the neonate’s external ear and nasopharynx. Clin Pediatr 1973; 12:697–700
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-36-2-117
Loading
/content/journal/jmm/10.1099/00222615-36-2-117
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error