Routine Skin Cultures in Predicting Sepsis Pathogens among Hospitalized Preterm Neonates in Bangladesh
Background: Few studies from developing countries have examined sensitivity, specificity, positive and negative predictive values of routine surface cultures. Objectives: The purpose of the study was to determine sensitivity, specificity, and positive predictive value (PPV) of skin cultures among pr...
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Published in | Neonatology (Basel, Switzerland) Vol. 94; no. 2; pp. 123 - 131 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Basel, Switzerland
S. Karger AG
01.01.2008
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Subjects | |
Online Access | Get full text |
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Summary: | Background: Few studies from developing countries have examined sensitivity, specificity, positive and negative predictive values of routine surface cultures. Objectives: The purpose of the study was to determine sensitivity, specificity, and positive predictive value (PPV) of skin cultures among preterm neonates admitted to Dhaka Shishu Hospital, Bangladesh. Methods: The study was nested within a prospective, randomized, controlled trial of emollient treatment in Dhaka Shishu Hospital, Bangladesh. A total of 497 preterm infants <33 weeks gestational age and <72 h of chronological age were enrolled, and the sensitivity, specificity, and PPV of skin cultures were analyzed among 3,765 blood-skin culture pairs, wherein the skin culture was obtained within 13 days before the blood culture. Results: Overall sensitivity, specificity, and PPV were 16, 38, and 5%, respectively. PPV during Klebsiella pneumoniae outbreaks was about 9%, and the inguinal site had the highest PPV (6%) among the three skin sites. Acinetobacter spp.- and K. pneumoniae-specific PPVs were 28 and 23%, respectively. PPV was <2% for Candida spp., Enterobacter spp., and Salmonella spp. Conclusion: Routine skin culture is inefficient in predicting the pathogen responsible for sepsis among premature neonates, even in a developing country setting, where the burden of bacterial infection is relatively high. Skin cultures are also of limited utility during K. pneumoniae outbreaks, and are not recommended. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-News-1 ObjectType-Feature-3 |
ISSN: | 1661-7800 1661-7819 |
DOI: | 10.1159/000119722 |