Alternative microbiological cultures in neonates with maternal-fetal infectious risk factors

Background. Early-onset sepsis remains an important issue among newborns, with a serious impact on both mortality and morbidity. Aim. The study aimed to determine the value of alternative cultures – gastric aspirate and external ear swab – in diagnosing neonatal infection in infants born at risk of maternal-fetal infection. Materials and methods. Endocervical cultures were obtained from mothers, while gastric aspirate or external ear swab samples were collected from neonates with maternal-fetal infection risk factors. Infection diagnosis relied on clinical signs, hematological findings, and acute-phase proteins. Results. One hundred seventy-three newborns with maternal-fetal risk factors were investigated. Vaginal swabs were obtained from all mothers, and two types of microbiological culture were collected from neonates: 164 gastric aspirate samples and 108 external ear swabs. Among the neonatal cultures, 15 (8.6%) tested positive for pathogens, including Staphylococcus, Klebsiella spp., and Haemophilus influenzae. Paraclinical findings were correlated with the clinical status. Out of the positive cultures, infection diagnosis was confirmed in almost all cases, with only two being counted as colonization. The external ear swab exhibited a higher tendency for bacterial growth (66.7% vs. 15%). Conclusions. Both gastric aspirate and external ear swab reflect the microbial composition of the amniotic fluid; thus, they can serve as alternative microbiological samples for neonates at risk of maternal-fetal infection. The external ear swab demonstrated a stronger propensity for positive culture results. While these alternative cultures can be used as screening tools, blood culture remains the gold standard for diagnosis.