Abstract
Nosocomial infections are the most common complications encountered in the neonatal intensive care unit (NICU). They are associated with high mortality and prolonged duration of hospitalization in the survivors, contributing to an increased cost of health care. In this article, we review the literature on the value of routine endotracheal aspirate cultures for the prediction of neonatal sepsis and provide guidelines to prevent nosocomial infections. Upon reviewing the literature it appears that the practice of routine cultures of endotracheal aspirate and cultures obtained from multiple body sites is an expensive proposition with low yield. The sensitivity of this test is at best 50% and all studies report a very low positive predictive value. The specificity of this test is 80%, hence its role is mainly limited to identifying infants who are at low risk for sepsis. As we do not have any reliable test for early diagnosis of neontal sepsis and also to dientify infants at high risk for sepsis, our main emphasis should be towards preventing nosocomial infections. Guidelines for reducing nosocomial infections are described.
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Sprunt K, Leidy G, Redman W. Abnormal colonization of neonates in an intensive care unit: means of identifying neonates at risk of infection.Pediatr Res 1978; 12: 998–1002.
Harris H, Wirtschafter D, Cassady G. Endotracheal intubation and its relationship to bacterial colonisation and systemic infection of newborn infants.Pediatrics 1976; 58: 816–823.
Issacs D, Wilkinson AR, Moxon ER. Surveillance of colonization and late onset septicemia in neonates.J of Hosp Infect 1987; 10: 114–119.
Slagle TA, Bifano EM, Wolf JW, Gross SJ. Routine endotracheal cultures for the prediction of sepsis in ventilated babies.Arch Dis Child 1989; 64: 34–38.
Lau YL, Hey E. Sensitivity and specificity of daily tracheal aspirate cultures in predicting organisms causing bacteremia in ventilated neonates.Pediatr Infect Dis J 1990; 10: 290–294.
Evans ME, Schaffner W, Federspeil F, Cotton RB, McKee KT, Stratton CW. Sensitivity, specificity and predictive value of body surface cultures in a neonatal intensive care unit.JAMA 1988; 259: 248–252.
Goldmann DA. Bacterial colonization and infection in the neonate.Am J Med 1981; 70: 417–422.
Goldmann DA, Leclair J, Macone A. Bacterial colonization of neonates admitted to an intensive care environment.J Pediatr 1978; 93: 288–292.
Coventry KJ, Isbiter C. A bacteriological and clinical study of infection in newborn babies in a maternity hospital nursery.Med J Aust 1951; 2: 394–396.
Centers for Disease Control. Update: Universal precautions for the prevention of transmission of HIV, hepatitis B virus and other blood borne pathogens in health care settings.MMWR 1988; 37: 377–382, 387–388.
Lynch P, Jackson MM, Cummings, The role of isolation practices in the prevention of nosocomial infections.Am Int Med 1987; 107: 243–246.
Garner JS, Simmons BP. CDC Guidelines for isolation precautions in hospitals.Infect Control 1983; (suppl): 245–325.
Planning and Design for perinatal facilities. Columbus, Ohio, Ross Laboratories, 1977.
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Srinivasan, H.B., Vidyasagar, D. Endotracheal aspirate cultures in predicting sepsis in ventilated neonates. Indian J Pediatr 65, 79–84 (1998). https://doi.org/10.1007/BF02849697
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DOI: https://doi.org/10.1007/BF02849697