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脐血培养在早发型新生儿败血症中的应用价值。

Utility of cord blood culture in early onset neonatal sepsis.

作者信息

Meena Jothi, Charles Marie Victor Pravin, Ali Arunava, Ramakrishnan Siva, Gosh Seetesh, Seetha Kunigal S

机构信息

Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.

Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India.

出版信息

Australas Med J. 2015 Aug 31;8(8):263-7. doi: 10.4066/AMJ.2015.2460. eCollection 2015.

Abstract

BACKGROUND

Neonatal sepsis is a major cause of neonatal mortality. The clinical outcome mainly depends on the early diagnosis and peripheral venous blood culture (PVBC) is the most widely practiced diagnostic method.

AIMS

This study aimed to evaluate the utility of umbilical cord blood culture (UCBC) in neonates at high risk of early onset neonatal sepsis (EONS) in comparison to peripheral venous blood culture.

METHODS

A total of 40 neonates with two or more risk factors for EONS were included in the study. Umbilical cord blood was collected aseptically during delivery for blood culture and C-reactive protein (CRP). Peripheral venous blood was collected within 24 hours of birth for sepsis screen and PVBC.

RESULTS

Although 11 babies were sepsis screen positive, cord blood CRP was negative in all cases. In comparison to PVBC, UCBC had 100 per cent sensitivity and 94.9 per cent specificity. The results of UCBC were consistent with PVBC. One neonate who was both UCBC and PVBC positive also had isolation of the same pathogen in both the cultures and 33 per cent PPV for UCBC.

CONCLUSION

UCBC is a simple convenient method, which ensures culture of adequate volume of blood from newborns allowing effective early isolation of bacterial pathogens, especially in EONS.

摘要

背景

新生儿败血症是新生儿死亡的主要原因。临床结果主要取决于早期诊断,而外周静脉血培养(PVBC)是应用最广泛的诊断方法。

目的

本研究旨在评估脐血培养(UCBC)与外周静脉血培养相比,在早发型新生儿败血症(EONS)高危新生儿中的应用价值。

方法

共有40例具有两种或更多EONS危险因素的新生儿纳入研究。分娩期间无菌采集脐血进行血培养和C反应蛋白(CRP)检测。出生后24小时内采集外周静脉血进行败血症筛查和PVBC检测。

结果

尽管11例婴儿败血症筛查呈阳性,但所有病例的脐血CRP均为阴性。与PVBC相比,UCBC的敏感性为100%,特异性为94.9%。UCBC的结果与PVBC一致。1例UCBC和PVBC均为阳性的新生儿在两种培养物中均分离出相同病原体,UCBC的阳性预测值为33%。

结论

UCBC是一种简单方便的方法,可确保从新生儿采集足够量的血液进行培养,从而有效早期分离细菌病原体,尤其是在EONS中。

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