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Am J Perinatol 2018; 35(08): 764-768
DOI: 10.1055/s-0037-1615794
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Traumatic Neonatal Lumbar Punctures: Experience at a Large Pediatric Tertiary Care Center in Canada

Adela Matettore
1   Department of Pediatric Intensive Care, BC Children's Hospital, Vancouver, British Columbia, Canada
,
Tobias R. Kollmann
2   Division of Infectious and Immunological Diseases, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada
› Author Affiliations
Further Information

Publication History

25 June 2017

21 November 2017

Publication Date:
29 December 2017 (online)

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Abstract

Objective Contamination of cerebrospinal fluid (CSF) by blood during neonatal lumbar puncture (LP) is common and poses diagnostic difficulties. Our objectives were to determine the number of traumatic LPs performed at the BC Children's Hospital over 9 years and whether there was an association between traumatic LPs and demographic variables, hospital location, or time of the procedure.

Study Design This study was a retrospective review of neonatal CSF samples from May 2006 to March 2015. The data were analyzed to establish the rate of traumatic samples and whether there was an association between traumatic LPs and demographic variables (age, gender), location of procedure, positive CSF culture, and/or timing of the procedure.

Results A total of 1,263 LPs were reviewed, 47.7% (n = 602) were contaminated with >400 red blood cells/high-power field. The median age of neonates whose samples were uncontaminated was 10.580 days compared with 6.535 days in the group with contaminated samples (z =  − 2.884, p = 0.004). None of the other factors studied was associated with traumatic taps. Detected organisms included Escherichia coli (n = 12), coagulase-negative Staphylococcus (n = 7), Enterococcus faecalis (n = 3), and group B Streptococcus (n = 2).

Conclusion Nearly half of all CSF samples in the study period were contaminated. Traumatic samples were more common in younger neonates.

Keywords

neonatal sepsis - meningitis - lumbar puncture
 

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