Abstract
Blood culture remains the gold standard for diagnosing neonatal septicemia. Although
automated continuous monitoring blood culture systems have generally been shown to
be superior to conventional manual systems, there are few data relating to their use
specifically in neonates. The aim of this study was to compare the manual method of
blood culture with an automated BacT/Alert 3D system for detection of neonatal septicemia
in terms of rate of recovery of pathogens and time to positivity. One hundred and
one matched pairs of blood culture specimens from patients on a neonatal intensive
care unit were evaluated by the two methods. The yield of significant pathogens with
the BacT/Alert 3D system was 45.5%, compared with 18.8% with the manual method (P < 0.0001). Moreover, streptococci, which are important neonatal pathogens, were detected
exclusively with the automated system. The median time to positivity with the automated
system was 11.5 h, compared with 24 h for the manual system. The BacT/Alert 3D system
offers more sensitive and rapid detection of neonatal septicemia than a manual blood
culture method. The clinical benefits of this may justify the additional cost of automated
blood culture systems in developing countries where manual systems currently remain
commonplace.
Keywords
Neonatal septicemia - automated systems - BacT Alert 3D system - manual/conventional
blood culture
