What is the role of cultures in the workup of neonatal sepsis?

Updated: Jun 13, 2019
  • Author: Nathan S Gollehon, MD, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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Answer

Aerobic and anaerobic cultures are appropriate for most of the bacterial pathogens associated with neonatal sepsis. Anaerobic cultures are especially important in neonates who have abscesses, processes with bowel involvement, massive hemolysis, or refractory pneumonia. In one study, anaerobic infections were responsible for 16% of early-onset sepsis amongst very low birthweight infants. [40]  

Bacterial culture results should generally reveal the organism of infection within 36-48 hours; subsequent initial identification of the organism occurs within 12-24 hours of the growth. Single-site blood cultures are effective for isolating bacteria in neonates with sepsis, although obtaining two cultures from separate sites has been shown to be useful in determining if commensal species represent true infection or a contaminated sample. [40]  Blood culture from the umbilical cord may be considered. This route is attractive because larger volumes of blood may be drawn without concern, optimizing recovery of the offending organisms. However, contaminants have been reported at high rates in some, studies and specimen handling can be challenging. [41] Urine cultures are most appropriate for the investigation of late-onset sepsis.


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