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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Amniotic cavity cultures, blood cultures, and surface swabs in preterm infants – useful tools for the management of early-onset sepsis?

Angelika Berger1 / Armin Witt2 / Nadja Haiden3 / Veronika Kretzer4 / Georg Heinze5 / Arnold Pollak6

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Corresponding author: Dr. Angelika Berger, University Hospital Vienna, Department of Pediatrics, Waehringerguertel 18–20, A-1090 Vienna/Austria. Tel (hospital): +43-1-40400-5572, Tel (private): +0043-664-3969209, Fax: 0043-1-40400-3296, e-mail (hospital): , e-mail (private):

Citation Information: Journal of Perinatal Medicine. Volume 32, Issue 5, Pages 446–452, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2004.145, June 2005

Publication History

Received:
December 1, 2003
Revised:
February 2, 2004
Accepted:
February 5, 2004
Published Online:
2005-06-01

Abstract

Aims: To evaluate the potential benefit of amniotic fluid and amniotic/placental membrane cultures for the management of early-onset sepsis in preterm infants.

Methods: The results of amniotic cavity cultures obtained during cesarean section and of peripheral blood cultures and surface swabs obtained from the preterm infant at the time of admission were analyzed with respect to the diagnosis of clinical sepsis in 221 preterm infants <34 weeks of gestation.

Results: 136 (61.5%) patients had negative amniotic cavity culture results or growth of contaminants, 56 (25.3%) had growth of Ureaplasma urealyticum, and 29 (13.1%) of other pathogens. The corresponding numbers for surface swabs were 82.8%, 11.6%, and 5.6%. A positive blood culture was found in only two neonates. Fifty-four patients (24.4%) had clinical early-onset sepsis. Patients with amniotic cavity culture results that were positive for other pathogens were significantly more likely to experience clinical sepsis than patients with negative culture results (51.7% vs 15.1%, OR 6.1, p < 0.0001). Regarding surface swabs, this correlation did not reach statistical significance.

Conclusion: The strong association between positive amniotic cavity culture results and clinical early-onset sepsis supports the existence of a causal relation and provides evidence for the potential value of amniotic and/or placental membrane sampling in the management of early-onset sepsis in preterm infants. Surface swabs add no additional information and hence should not be performed routinely.

Keywords: Amniotic cavity culture; blood culture; early-onset sepsis; preterm infant; surface swab

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