Value of Endotracheal Aspirate Cultures Versus Blood Cultures in Predicting Sepsis in Ventilated Preterm and Full-Term Neonates
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- Category: Vol. 82, December 2014
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Value of Endotracheal Aspirate Cultures Versus Blood Cultures in Predicting Sepsis in Ventilated Preterm and Full-Term Neonates, LAILA H. MOHAMED, OLA A. EL-SISY, NERMIN R. MOHAMED, NAGY A. EL-HUSSIENY and DALIA B. MOHAMED
Abstract
Sepsis is a common complication in the NICU. The incidence of neonatal sepsis is 1-5/1000 livebirth and its mortality rate is 5-20%. Mechanical ventilation plays an important role because artificial airways bypass the body’s defense against inhaled pathogens and offer new routes for non airborne pathogens.
The goal of our work is to clarify the valuable comparison of endotracheal aspirate cultures versus blood cultures in order to predict sepsis in ventilated preterm and full term neonates. Sixty (60) full term (>!37 wks) & preterm (!937 wks) neonates with respiratory distress and mechanically ventilated in NICU with clinical evidence of sepsis were selected for our study. Our selected cases were subjected to clinical evaluation and to the Hematological Scoring System of Sepsis. The golden pearl in our study is the blood culture for any neonatal infant suggested clinically and by laboratory criteria to be neonatal sepsis.
We found that Endotracheal Aspirate (ETA) culture is not considered a gold standard as sensitivity and specificity in predicting sepsis in ventilated newborns is low in comparison to blood culture results, the rate of culture positivity increased as the birth weight decreased, gestation week got smaller and the duration of intubation prolonged.
Because of longer duration of mechanical ventilation, longer stay in the NICU, increased use of antibiotics, higher costs for healthcare, and most importantly, increased mortality, the prevention of VAP is the main priority. In spite of the great advances in the pathogenesis of VAP, intensivists still struggle with the prevention strategy.