ROLE OF UMBILICAL CORD BLOOD CULTURE IN DETECTION OF EARLY-ONSET SEPSIS IN HIGH-RISK NEONATES

Background: Early-onset neonatal sepsis (EONS) requires rapid diagnostic protocols to mitigate morbidity in high-risknewborns. This prospective observational study evaluated the clinical diagnostic precision of umbilical cord blood culture(UCBC) relative to the standard reference technique, peripheral vein blood culture (PVBC), for isolating pathogensassociated with EONS in neonates with maternal high-risk indicators. Materials and Methods: Pair-matched bloodsamplings were gathered under aseptic guidelines directly from the umbilical cord at delivery and via peripheralvenipuncture upon admission to the neonatal intensive care unit at Sharda Hospital, Greater Noida. The study examined 72high-risk infants. Diagnostic parameters, including sensitivity, specificity, positive predictive value (PPV), and negativepredictive value (NPV), were calculated using PVBC as the reference standard. Results: Active culture growth wasvalidated in 11.1% (n = 8) of the extracted UCBC specimens and 9.7% (n = 7) of the companion PVBC lines.Staphylococcus aureus and Escherichia coli represented the primary bacterial pathogens isolated. Compared with theperipheral venous standard, the UCBC approach yielded a diagnostic sensitivity of 88.9%, a specificity of 100%, a PPV of100%, and an NPV of 98.4%. Marked statistical associations were noted between overall culture positivity and baselinevariables of preterm delivery (p < 0.001) as well as low birth weight (p = 0.041). Conclusions: Umbilical cord bloodculturing yields high diagnostic accuracy indices that parallel standard peripheral venous sampling methods. It provides anon-invasive, painless, and practical technique to screen for early-onset infection at delivery without inflicting additionalprocedural pain on the infant. Clinically, utilizing UCBC on discarded tissues establishes a valid pre-antibiotic diagnosticwindow, addressing critical volume barriers in resource-limited infrastructure.