BACTERIOLOGIC EXAMINATION OF GASTRIC ASPIRATE (GA) AS A SCREEN FOR NEONATAL SEPSIS

Abstract

213 of 508 consecutive neonatal ICU admissions (Jan-June, 1983) had gastric aspirate cultures for prolonged rupture of membranes (>18 hrs), maternal fever, or respiratory distress at birth. To evaluate the use of GA cultures as a screen for neonatal sepsis or pneumonia, we compared GA culture results with clinical outcome, autopsy findings, radiologic diagnosis of pneumonia, and results of cultures from other sites. 18 of the 213 infants had confirmed sepsis or pneumonia, with and negative GA cultures distributed as shown in the table: 7 of 18 GA cultures (39%) in newborns with serious infections, including 6 of 8 (75%) in newborns with bacteremia, were for the specific pathogen found at other sites. 13 of 195 GA cultures (7%) gave positive results in newborns with no subsequent evidence of neonatal infection. 182 of 195 infants (93%) evaluated for infection because of perinatal risk factors, but with no subsequent supporting evidence for perinatal infection, had negative GA cultures. GA is easily obtained for culture and microscopic examination at birth. Bacteriologic examination of GA has a low rate of false results and may permit early recognition of bacterial pathogens in some newborns with serious perinatal infections.