Abstract
Background
Umbilical cord blood culture (UCBC) may have a diagnostic utility for early onset sepsis (EOS) detection in preterm infants. It may prevent sampling the newborn and collect a higher volume of blood for pathogenic identification.
Methods
Retrospective analysis at a tertiary care center in Canada of preterm infants ≤ 34 0/7 weeks’ gestation with UCBC taken at birth.
Results
Of 505 admitted infants, 195 had UCBC. 170 UCBCs were negative; 44 of these had also negative neonatal blood culture (NBC). No infants with negative UCBC showed EOS symptoms in the first week of life. 25 UCBCs were positive: 18 were contaminants (all with negative NBC) and 7 were confirmed as EOS. 18 infants with UCBC contaminants remained asymptomatic. 7 EOS cases were identified, with varying bacteriological profiles; 5 displayed sepsis symptoms while 2 were asymptomatic. Risk of EOS increased with prolonged rupture of membranes.
Conclusions
UCBC effectively detected EOS establishing it as a method with possibly better diagnostic performance than NBC in high-risk neonates. Further studies are needed to improve UCBC technique and lower contamination rates.
Impact
Umbilical cord blood culture has a higher bacterial identification rate than peripheral venous blood culture for the early identification of early-onset sepsis in preterm infants.
Umbilical cord blood cultures that showed no growth were reliable predictors of not developing early onset sepsis.
Umbilical cord blood culture should be considered as part of the evaluation for early onset sepsis in the preterm infants.
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Data availability
Deidentified individual participant data will be made available to researchers who make a methodologically sound proposal. Proposals should be submitted to brahim.bensouda@umontreal.ca.
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Drs Brahim Bensouda, Romain Mandel and Nabeel Ali conceptualized and designed the study, collected data, drafted the initial manuscript, reviewed, and revised the manuscript. Dr Altit reviewed and revised the manuscript. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of work.
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Bensouda, B., Mandel, R., Altit, G. et al. Umbilical cord blood culture for early onset sepsis in preterm infants. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03183-7
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DOI: https://doi.org/10.1038/s41390-024-03183-7
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