Neonatal sepsis : risk factors and diagnosis using BACTEC system

Abstract EN

Background : Neonatal sepsis is a low incidence, high-risk disease with many sepsis work-ups performed to detect a single case.

Seventy-two hours of antibiotic therapy have been traditionally recommended pending negative culture results.

Improved culture media and new technology integrated into blood culture systems could shorten incubation time required to detect positive culture results.

This would then change the length of antibiotic therapy in the management of the newborn infant with suspected sepsis.

Aims : Evaluation of the BACTEC system as a rapid and reliable method for detection of neonatal sepsis.

Methods : Blood samples from 150 newborn infants with suspected sepsis were tested to evaluate the time of incubation to detect positive blood cultures using BACTEC 9050 (Becton Dickinson, Sparks, Md.) and at the same time analyzing possible risk factors altering the incidence of neonatal sepsis.

Results : The study showed that coagulase negative staph "CON5" were the most common late onset pathogen.

Birth weight gestational age and duration of mechanical ventilation were strongly associated with risk of neonatal bacteremia and seventy two hours was the maximum duration of incubation to achieve positive culture results in nearly all cases.

Conclusion : New systems for quick and accurate detection of positive blood culture results may serve as an impetus to re-evaluate the recommendations for the length of antibiotic therapy for suspected bacteremia with negative culture results.