Two Sites Blood Cultures Compared to Standard Single Site Blood Culture in Diagnosis of Neonatal Sepsis

Abstract

Objective: To compare the yield of two sites blood cultures versus standard single site blood culture for the diagnosis of neonatal sepsis.

Study Design: Randomized Controlled Trial study

Place and Duration of Study: This study was conducted at the Neonatal Unit of Pediatric Medicine Unit-II, Mayo Hospital Lahore from March 1^st, 2019 to August 31^st, 2019.

Materials and Methods: 70% isopropyl alcohol were used to clean the skin upto 30 seconds to collect blood cultures, then cleaned again with 51-2% tincture of iodine and isopropyl alcohol. Blood samples of 11 mL were taken from each of the two peripheral veins and were inoculated into vials of BactT/Alert (Paed Plus). Observe cultures for 5 days before reporting a negative result. Single blood culture was taken of group-A and two blood culture was taken from group-B. In group- B, even single positive blood cultures were taken as significant and its yield was compared with group-A. Data were analyzed using SPSS v25.20. Data were stratified for age and gender to deal with effect modifiers. Post-stratification, Chi-Square was applied. A p-value ≤0.05 was considered significant.

Results: Total 150 neonates with suspected sepsis were enrolled for this study. Neonates were divided into two groups i.e. Group-A (Single site blood culture) and Group-B (Two site blood culture). In group-A, 54(72.40%) patients were male and 21(28.0%) were female. In group-B, 44 (58.7%) patients were male and 31 (41.3%) were female. In group-A, mean age was 14.94±7.69 days and 13.85±7.44 days in group-B. In single site blood culture group, 23 (30.7%) patients had positive yield and 42(56.0%) patients had positive yield two site blood culture group with a p-value of 0.002, which is statistically significant.

Conclusion: Two blood cultures collected synchronously from 2 places to increase pathogen detection rates as compare to conventional 1 culture blood.