Hamedi Abdolkarim, Mamoury Gholam Ali, Akhlaghi Farideh
Department of Pediatric Infectiousman, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Acta Med Iran. 2010 Jul-Aug;48(4):231-3.
Neonatal sepsis is an important cause of death and morbidity in newborns and is diagnosed by isolation of organism in blood culture. In several reports,reliability of blood cultures were done from umbilical catheters,have been demonstrated. The objective of the present study was to determine, wether an indewelling umbilical catheter, could be an alternative site for blood culture. In a prospective study over 6 months during 2006, 141 paired blood cultures from 134 infant,were done simultaneously from peripheral site and umbilical catheter (mostly U. V. C),during the first four days of life. Majority of these infants were preterm and admitted to NICU for special care. these infants had indwelling umbilical line and had indication of sepsis workup. A total of 141 pairs of blood cultures were obtained from 134 infants. In 16 infants blood culture pairs were positive for one organism in both peripheral vein and umbilical site. 71. 6% of total cultures (n=11) pairs were negative in both sites. A total of 22 pairs were positive in one site only,with 5 positive from peripheral vein only and the other 17 from umbilical site. Two pairs were positive in both sites with two different organism. In over all 16 infant (11%) of blood were considered to be contaminated. Contamination rate were 2. 4% and 9. 2% for peripheral and umbilical catheter site. Contamination rate increased after 48 hours of age in umbilical catheter. The result showed that after 2 days contamination rate for blood culture taken from catheter line increased and specificity decreased. We recommended that blood culture via umbilical catheter in first 2 days in sick neonates with indwelling catheter can be a alternate site of blood culture sampling.
新生儿败血症是新生儿死亡和发病的重要原因，通过血培养分离出病原体来进行诊断。在一些报告中，已证明经脐静脉导管进行血培养的可靠性。本研究的目的是确定留置脐静脉导管是否可作为血培养的替代部位。在2006年为期6个月的一项前瞻性研究中，对134名婴儿在出生后的头四天同时从外周部位和脐静脉导管（大多数是脐静脉导管）采集了141对血培养样本。这些婴儿大多数为早产儿，因特殊护理入住新生儿重症监护病房。这些婴儿留置了脐静脉导管且有败血症检查的指征。共从134名婴儿身上获取了141对血培养样本。在16名婴儿中，外周静脉和脐部的血培养样本对一种病原体均呈阳性。总培养样本对（n = 11）中有71.6%在两个部位均为阴性。共有22对仅在一个部位呈阳性，其中5对仅外周静脉呈阳性，另外17对脐部呈阳性。有两对在两个部位对两种不同病原体呈阳性。总体而言，16名婴儿（11%）的血培养被认为受到污染。外周和脐静脉导管部位的污染率分别为2.4%和9.2%。脐静脉导管在出生48小时后污染率增加。结果表明，导管留置两天后，从导管采集血培养的污染率增加且特异性降低。我们建议，对于留置导管的患病新生儿，在出生后头两天通过脐静脉导管进行血培养可作为血培养采样的替代部位。
