EVALUATION OF ALTERNATIVE HEMOCULTURE TES TS FOR THE DIAGNOSIS OF EARLY NEONATAL SEPSIS

In order to evaluate the diagnostic usefulness of coadjuvant tests suc h as external auditory canal swab culture and cultures from nasopharyn geal and gastric aspirates, and to determine the incidence and etiolog y of early neonatal sepsis (ENS) at our Unit, go newborn cases whose m others experienced premature rupture of the membranes (PRM) were studi ed prospectively. Although a firm diagnosis requires positive blood cu ltures, the difficulty in recovering microorganisms and the trauma ind uced by sample collection in the baby justify the search for alternati ve diagnostic tests. Out of 2293 childbirths during 1991, 90 mothers ( 4%) had PRM more than 24 hours pre-partum, while 6.9 parts per thousan d (16/2293) developed ENS. In newborns from PMR mothers, ENS percentag e was 3.3%, but increased to 5.5% in association with chorionamnioniti s and reached 8.8% in premature cases. Among etiological ENS agents, G ram-positive microorganisms predominated (Table 1), particulary Staphy lococcus aureus. Despite the finding that none of the coadjuvant assay s (Table 2) had sufficient sensitivity or positive predictive value to identify all septic cases, they may prove useful to pinpoint newborns at high risk due to amniotic fluid exposure to infection or to chorio amnionitis.