Utility of cord blood culture in early onset neonatal sepsis

Background: Neonatal sepsis is a major cause of neonatal mortality. The clinical outcome mainly depends on the early diagnosis and peripheral venous blood culture (PVBC) is the most widely practiced diagnostic method.

Aims: This study aimed to evaluate the utility of umbilical cord blood culture (UCBC) in neonates at high risk of early onset neonatal sepsis (EONS) in comparison to peripheral venous blood culture.

Methods: A total of 40 neonates with two or more risk factors for EONS were included in the study. Umbilical cord blood was collected aseptically during delivery for blood culture and C-reactive protein (CRP). Peripheral venous blood was collected within 24 hours of birth for sepsis screen and PVBC.

Results: Although 11 babies were sepsis screen positive, cord blood CRP was negative in all cases. In comparison to PVBC, UCBC had 100 per cent sensitivity and 94.9 per cent specificity. The results of UCBC were consistent with PVBC. One neonate who was both UCBC and PVBC positive also had isolation of the same pathogen in both the cultures and 33 per cent PPV for UCBC.

Conclusion: UCBC is a simple convenient method, which ensures culture of adequate volume of blood from newborns allowing effective early isolation of bacterial pathogens, especially in EONS.