Simultaneous Two-site Blood Culture for Diagnosis of Neonatal Sepsis.

OBJECTIVE: To evaluate efficacy of two blood cultures taken simultaneously from two different sites as compared to standard practice of single blood culture in diagnosis of neonatal sepsis.

STUDY DESIGN: Prospective cohort study.

Setting: A tertiary-care center at a public hospital.

PARTICIPANTS: 475 neonates admitted to intensive care unit with suspected sepsis, from August 2014-July 2015.

INTERVENTION: Two blood cultures drawn from two different peripheral veins in patients with suspected neonatal sepsis.

MAIN OUTCOME MEASURES: Increase in culture-positivity rate with use of two blood cultures.

RESULTS: 475 babies with suspected sepsis were enrolled. 185 patients had only first culture positive (38.9%). When we added second culture positivity, yield increased to 221 (46.5%). Adding on second culture increased the culture yield by 36 (7.6%; 95% CI 2.41 to 12.79; P=0.018). The most common organisms isolated were E. coli, S. aureus and Candida spp. Major morbidities and mortality were more common in blood culture positive patients Contamination was ruled out in 25 babies who grew Coagulase negative Staphylococcus (CONS) (n=10) and Candida spp. (n=15) in either of the two cultures.

CONCLUSION: Two blood cultures taken simultaneously from two different sites improve rate of pathogen detection as compared to routine practice of single blood culture.