Early umbilical bacterial colonization in relation to blood culture in neonates admitted to two neonatal intensive care units in Khartoum City, Sudan

Abstract

Background: Umbilical colonization has long been used as an indicator of early neonatal infections.Factors related to the mother, baby or the environment has been involved in the acquirement of colonizersand even developing neonatalsepsislater on. Thisstudy aimed to assessthe relation between early umbilicalbacterial colonization and blood culture in neonates admitted to two Neonatal Intensive Care Units inKhartoum City, Sudan.Materials and Methods: Eighty neonatessuspected to have sepsis were included in the study. Umbilicalswabs were taken in the first twelve hours of life and were sent for culture. The results were then comparedto the results of blood cultures to find if there was any matching between the grown organisms. Neonates’and mothers’ information were obtained by an interview and documented in data collection sheets.Results: Umbilical colonization was present in 20% (n=16) of the study population while 21.25% (n=17)had positive blood cultures. Of the colonized group, Staphylococcus aureus was the commonest organismisolated (n=6, 37.5%), followed by Pseudomonas spp. (n=3, 18.8%) and Klebsiella spp. (n=2, 12.5%).While in those with positive blood culture Pseudomonas spp. predominated (n=7, 41.2%).followed byklebsiella spp. (n=5, 29.4%) and Staphylococcus aureus (n=3, 17.6%); 58.8% (n=47) of the patients had nogrowth in swabs or blood cultures, while positive results showed no matching (p value=0.009).Conclusion: Umbilical swab culture had a negative predictive value of 81% for early neonatal (bloodculture positive) infection, 36% positive predictive value, specificity of 84% and sensitivity of 31%.Therefore, in this study umbilical swab culture was a poor indicator for bacteraemia (sepsis) in the newborn.