Diagnostic value of umbilical cord blood culture compared to sepsis screening in high-risk neonates

Neonatal septicaemia significantly contributes to neonatal morbidity and mortality, particularly in developing countries. While peripheral venous blood culture and sepsis screening are gold standards for diagnosing early-onset sepsis (EOS), their sensitivity is limited due to small sample volumes, intrapartum antibiotic use, and prior antibiotic administration. Umbilical cord sampling offers advantages such as being painless, requiring less skill, and allowing early, sufficient sampling for faster evaluation and treatment initiation. This study compares umbilical cord blood culture (UCBC) with sepsis screening in EOS among high-risk neonates. To compare the diagnostic performance of UCBC and sepsis screening in neonates at high risk for EOS. A prospective analytical study was conducted from June 2022 to February 2024 on 62 high-risk newborns in KIMS, Hubballi. UCBC samples were collected immediately after delivery, inoculated into BACT/ALERT bottles, and sent for bacterial culture. Upon NICU admission, sepsis screening was performed. Data was analysed using descriptive and inferential statistics, comparing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of both methods. In this study among 62 neonates, UCBC showed a sensitivity of 57.89%, specificity of 97.67%, positive predictive value of 91.67%, and negative predictive value of 84.00%. The ROC curve (AUC 0.78) indicated moderate diagnostic accuracy compared to sepsis screening. UCBC is an easy to perform and early diagnostic tool in EOS with a high PPV (91.67%). But due to lower sensitivity (57.89%), it should be complemented with additional methods to optimise diagnosis in neonates at risk.