Rapid Diagnosis of Neonatal Bacteremia Using Polymerase Chain Reaction

Infections in the neonate are the most important causes of mortality and hospitalizations in the neonatal practice. In the present study, 180 neonates with criteria for probable sepsis admitted to neonatal intensive care unit in Ahmad Maher Teaching hospital, Cairo Egypt were investigated for evidence of sepsis. The investigation protocol included sepsis screen, blood culture and molecular analysis by polymerase chain reaction (PCR) for bacterial DNA component encoding 16S rRNA in all cases. We compared the results of PCR with blood culture and other markers of sepsis screen. Blood cultures were positive in 80 (44.4%) cases with sensitivity of 91.9%. PCR was positive in 87(48.3%) cases (49 of them are with positive blood culture, CRP and buffy coat test). The sensitivity of PCR was 100% and specificity was 93%. The negative predictive value was 100%. The study concluded that although blood culture is a reliable method for diagnosis of neonatal sepsis, the universal bacterial primer PCR is a useful test and superior to blood culture for early diagnosis of sepsis in neonates. Consequently unnecessary treatment with antibiotics could be avoided.