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Use of Umbilical Cord Blood Culture for Detection of Neonatal Bacteremia

From the Departments of Obstetrics and Gynecology and of Pediatrics, University of Pennsylvania School of Medicine; and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Abstract

Rapid and accurate detection of neonatal bacteremia is an important part of the management of the neonate with suspected sepsis. This study compared the incidence of positive umbilical cord blood cultures (UCBCs) to the incidence of positive peripheral venous blood cultures and determined whether a meticulous UCBC technique prevented contamination of culture specimens. Six UCBCs of the 200 sampled were positive. Three cultures exhibited delayed growth (more than 48 hours) and were not considered clinically significant. In 2 of the 3 remaining positive cultures were organisms considered contaminants; the third culture correlated to the infant's peripheral venous blood culture (-hemolytic streptococcus), showing evidence of bacteremia. From these data the authors conclude that 1) meticulous and fastidious collection of UCBCs prevents contamination of culture specimens, and 2) the UCBC may prove to be a satisfactory alternative to the postnatal peripheral venous blood culture for detection of neonatal bacteremia.