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Umbilical cord blood culture for early onset sepsis in preterm infants

Pediatric Research (2024)Cite this article

Abstract

Background

Umbilical cord blood culture (UCBC) may have a diagnostic utility for early onset sepsis (EOS) detection in preterm infants. It may prevent sampling the newborn and collect a higher volume of blood for pathogenic identification.

Methods

Retrospective analysis at a tertiary care center in Canada of preterm infants ≤ 34 0/7 weeks’ gestation with UCBC taken at birth.

Results

Of 505 admitted infants, 195 had UCBC. 170 UCBCs were negative; 44 of these had also negative neonatal blood culture (NBC). No infants with negative UCBC showed EOS symptoms in the first week of life. 25 UCBCs were positive: 18 were contaminants (all with negative NBC) and 7 were confirmed as EOS. 18 infants with UCBC contaminants remained asymptomatic. 7 EOS cases were identified, with varying bacteriological profiles; 5 displayed sepsis symptoms while 2 were asymptomatic. Risk of EOS increased with prolonged rupture of membranes.

Conclusions

UCBC effectively detected EOS establishing it as a method with possibly better diagnostic performance than NBC in high-risk neonates. Further studies are needed to improve UCBC technique and lower contamination rates.

Impact

  • Umbilical cord blood culture has a higher bacterial identification rate than peripheral venous blood culture for the early identification of early-onset sepsis in preterm infants.

  • Umbilical cord blood cultures that showed no growth were reliable predictors of not developing early onset sepsis.

  • Umbilical cord blood culture should be considered as part of the evaluation for early onset sepsis in the preterm infants.

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Fig. 1: UCBC and PVBC results.

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Data availability

Deidentified individual participant data will be made available to researchers who make a methodologically sound proposal. Proposals should be submitted to brahim.bensouda@umontreal.ca.

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Funding

No external funding was received for this study.

Author information

Authors and Affiliations

  1. Maisonneuve-Rosemont Hospital and University of Montreal, Department of Pediatrics, Montréal, QC, Canada

    Brahim Bensouda, Romain Mandel & Nabeel Ali

  2. Montreal Children’s Hospital and McGill University Health Center, Department of Pediatrics, Montréal, QC, Canada

    Gabriel Altit

Authors
  1. Brahim Bensouda
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  2. Romain Mandel
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  3. Gabriel Altit
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  4. Nabeel Ali
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Contributions

Drs Brahim Bensouda, Romain Mandel and Nabeel Ali conceptualized and designed the study, collected data, drafted the initial manuscript, reviewed, and revised the manuscript. Dr Altit reviewed and revised the manuscript. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of work.

Corresponding author

Correspondence to Brahim Bensouda.

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The authors declare no competing interests.

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Patient consent was not required for this study.

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Bensouda, B., Mandel, R., Altit, G. et al. Umbilical cord blood culture for early onset sepsis in preterm infants. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03183-7

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