Reducing contamination in umbilical cord blood cultures for the diagnosis of early onset neonatal sepsis at Windsor Regional Hospital: A prospective cohort quality improvement study
Dr. Telford Yeung
Windsor Regional Hospital
FUNDER: Tayfour-Emara Excellence in Research & Education Fund
Early onset neonatal sepsis (EONS) is characterized by bacteremia or bacterial meningitis that onsets within the first 72 hours of life. In Canada, 1 in 200 infants admitted to NICUs developed EONS, resulting in substantial morbidity and mortality of infants born at any gestational age. Diagnosing EONS requires one milliliter of blood but obtaining this volume can be challenging. To address this concern, umbillical cord blood culture (UCBC) has emerged as an alternative to peripheral blood culture (PBC), in which collection of a larger blood volume is easier and the procedure obviates neonatal pain. Windsor Regional Hospital is one of the two Canadian sites that use UCBC in their standard practice. Through the continued use of UCBC for the diagnosis of EONS, the hope is to reduce the contamination (false positive) rate from the current 6.7% to less than 3% within 12 months.
By reducing the comtamination rates in UCBC for EONS diagnosis, this will decrease the duration of NICU hospitalization in addition to antibiotic utilization. It will also allow UCBC to become the standard practice at other Canadian sites, rather than just the current two, Windsor Regional Hospital and London Health Sciences Centre.