Windsor Regional Hospital
Schulich School of Medicine & Dentistry
Early onset neonatal sepsis (EONS) is associated with significant morbidity and mortality. The diagnosis requires identifying a pathogen in blood but obtaining an adequate volume for peripheral blood culture (PBC) can be a challenge. As such, umbilical cord blood culture (UCBC) has become an alternative to PBC that is easier to collect with a larger blood volume. However, contaminants can be present with UCBC, giving rise to false positive cultures. Currently, the Windsor Regional Hospital (WRH) neonatal intensive care unit (NICU) has adopted UCBC, but the clinical impact of this practice has not been reviewed.
The objective of this study is to determine the sensitivity and specificity of UCBC versus PBC from paired samples for the diagnosis of EONS. Using retrospective data from January 2019 to December 2021, infants who are admitted to NICU with blood culture for evaluation of EONS will be included. Infants not born at WRH will be excluded. Clinical demographics along side blood culture results, antibiotic usage and duration of hospitalization will be collected. The implications of these results will be used to evaluate the local practice, which can be an opportunity for quality improvement. For cases of false positive cultures, we will review processes to minimize bacterial contamination during blood sampling. If the local practice demonstrates a sensitivity at 90% or greater, then a national prospective observational study may be the next step prior to advocating the widespread adoption of this practice.