A PROSPECTIVE COMPARATIVE STUDY OF UMBILICAL CORD BLOOD CULTURE VERSUS PERIPHERAL VENOUS BLOOD CULTURE IN DIAGNOSIS OF EARLY ONSET NEONATAL SEPSIS IN PRETERM NEONATES IN NEONATAL INTENSIVE CARE UNIT OF TERTIARY CARE HOSPITAL

Abstract

Background Neonatal sepsis is major cause of neonatal morbidity and mortality. Blood culture and sensitivity is gold standard for the diagnosis of neonatal sepsis. Low sensitivity of blood culture especially in newborn is due to small volume of blood sample collected from neonates and antibiotics given before sampling. Study Methodology A prospective, analytical, cross sectional study where comparison of umbilical cord blood culture and peripheral venous blood culture was done in 100 inborn neonates . Sensitivity and specificity, positive and negative predictive values were calculated. P value was calculated, Chi Square test was applied and association was quantified. Results Higher sensitivity(81.0%) and accuracy(87%) for predicting disease outcome of patients by UCBC method against PVBC method conclude that UCBC can be used as reliable and alternate tool to predict final outcome. Conclusion UCBC can be useful diagnostic test for EONS. Adequate amount of blood is obtained by umbilical cord method which can be difficult to obtain in a low birth weight new born. Inadequate samples of PVBC can lead to a false negative report. Umbilical cord blood is obtained from placental end of umbilical cord, there are less chances of introducing iatrogenic infection unlike routine culture technique where chances of false positive and risk of introducing iatrogenic infection is high. If umbilical cord blood is taken at birth, normal appearing newborn could be followed up in postnatal wards and discharged if reports are normal. If umbilical cord blood is collected at birth and culture report comes positive,we can prevent sequelae of sepsis by providing antibiotics for fixed duration and for units practising empirical antibiotics , antibiotics can be discontinued if report is negative.