Respiratory tract culture: could it be an additional diagnostic modality of neonatal sepsis?

ABSTRACT

Study objective is to evaluate the role of respiratory tract colonization pattern-in predicting pathogens isolated during episodes of neonatal sepsis. A prospective study including 50 septic newborns [21 full term and 29 preterm] was carried in the neonatal intensive care units [NICUs] of Cairo University [Kasr el Aini and Abou el Riche Children Hospital] during the period between March 2007 and December 2007. In addition to routine laboratory work up for sepsis, culture was performed on respiratory specimens obtained using either blind [non bronchoscopic] bronchoalveolar lavage [BAL] or tracheal aspirate [TA]. Comparing blood and respiratory cultures regarding the presence of bacterial growth, there was a statistically significant relation between them; as we retrieved the same organism in almost 30% of cases. In conclusion, Culture of tracheal secretions could be of use as an indicator of changes taking place in the NICU environment. However, it is recommended only if clinical signs point out pneumonia, associated with variation in amount and character of secretions, even if the chest x-ray shows no abnormality. Cultures of tracheal aspirates could not substitute the blood culture in diagnosis of neonatal sepsis