Bacterial and Fungal Infections in the Neonate: Current Diagnosis and Therapy
A positive blood culture with a clinically recognized pathogen remains the gold standard for the diagnosis of neonatal sepsis. Debate continues as to whether multiple blood cultures should be performed. Certainly with bacterial organisms that are frequent blood culture contaminants, such as coagulase-negative staphylococci (CoNS), the diagnosis of sepsis is best confirmed by the finding of two or more positive cultures from multiple sites or body fluids that are normally sterile. The isolation of CoNS from only one blood culture when only one is obtained is problematic and of uncertain significance. Since many of these positive cultures represent contamination with skin microflora, the practice of obtaining only one blood culture often leads to prolonged and unnecessary antibiotic therapy. In our neonatal intensive care unit (NICU) at Parkland Memorial Hospital (PMH) in Dallas, Texas, we routinely obtain two blood cultures from all infants who are evaluated for possible sepsis.
KeywordsBlood Culture Neonatal Intensive Care Unit Bloodstream Infection Positive Blood Culture Empiric Therapy
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- Saiman, L., Ludington, E., Dawson, J.D., Patterson, J.E., Rangel-Frausto, S., Wiblin, R.T. et al., and National Epidemiology of Mycoses Study Group. (2001). Risk factors for Candida species colonization of neonatal intensive care unit patients. Pediatr. Infect. Dis. J. 20, 1119–1124.PubMedCrossRefGoogle Scholar
- Sánchez, P.J., Gard, J.W., Dao, R., Leos, N.K., and Perlman, J. (1998). Impact of a protocol for reduction of vancomycin use in a neonatal intensive care unit. The 38th Interscience Conference on Antimicrobial Agents and Chemotherapy, September 24-27, 1998, San Diego, CA.Google Scholar
- Sánchez, P.J., Mohamed, W.A., Gard, J.W., Gaffney, D., Byrd, L., Zeray, F., and Leos, N.K. (1999). Use of a vancomycin-reduction protocol in a neonatal intensive care unit: What’s the outcome? Presented at the 37th Annual Meeting of the Infectious Diseases Society of America, November 1999, Philadelphia, PA.Google Scholar