Microbiological Study for Comparison between Broad Range 16S rDNA PCR and Conventional Blood Culture for Diagnosis of Sepsis in The Newborn

Document Type : Original Article

Authors

1 Department of Microbiology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

2 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.

Abstract

Background: Neonatal sepsis is major reason for mortality and morbidity in newborns. Blood culture is gold standard for identifying bacterial sepsis. Even so, it has low sensitivity and produces outcomes late. Bacterial DNA identification in blood samples could represent new diagnostic tool for identifying bacterial reason early on.
Aim of the work: To compare recognition of bacterial DNA in blood samples from neonates with assumed sepsis using broad range 16S rDNA PCR performed on all blood samples without prior enrichment and conventional blood culture.
Patients and Methods: This research included 90 neonates with clinically suspected neonatal sepsis in Al-Azhar Assiut University Hospital's Neonatal Intensive Care Units.  Minimum of two-three ml blood was collected from each neonate using standard sterile processes, one-two ml for conventional blood culture and one ml EDTA blood for PCR.
Results: There seemed to be 52 [57.8%] neonates who had positive bacterial blood culture outcomes with isolation of important microorganisms and 69 [76.7%] neonates who had positive PCR outcomes [16S rDNA gene detected]. Even so, 38 [42.2%] of neonates had negative bacterial blood culture outcomes and 21 [23.3%] had negative PCR outcomes [16S rDNA gene not detected]. 4 neonates with positive bacterial blood culture had negative PCR outcome, whereas 21 neonates had positive PCR despite negative bacterial blood culture, with significant difference among PCR and blood culture outcomes [p < 0.001]. The sensitivity values of PCR and blood culture were 97.3%, and 89.8% respectively and the specificity values of PCR and Blood culture were 95.0% and 86.7% respectively.
Conclusion: When routine cultures are negative, PCR strategy seems to be simple, reliable and valued complementary way for diagnosing neonatal sepsis in samples collected throughout antimicrobial therapy.

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