Gram's Stains of Tracheal Secretions Predict Neonatal Bacteremia FREE

Michael P. Sherman, MD; Kathleen H. Chance, MD; Boyd W. Goetzman, MD, PhD

Reprint requests to Department of Pediatrics, UCLA School of Medicine, Center for the Health Sciences, Los Angeles, CA 90024 (Dr Sherman).

Am J Dis Child. 1984;138(9):848-850. doi:10.1001/archpedi.1984.02140470048015.

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ABSTRACT

ABSTRACT | REFERENCES

• The presence of bacteria in tracheal secretions stained by the Gram method was evaluated as a method of predicting neonatal bacteremia. The presence of bacteria had a 74% sensitivity and a 47% predictive accuracy in identifying neonates with bacteremia before 12 hours of age. The specificity in predicting newborns without bacteremia was 98%. In the same neonates, an immature neutrophil-total neutrophil ratio of 0.2 or more had a 77% sensitivity in predicting neonates with bacteremia. Neonates with bacteria in their blood and tracheal aspirates, who died shortly after birth, had pneumonia on postmortem examination. In newborns who have respiratory distress and a risk of infection at birth, Gram's stains of tracheal secretions are a practical and useful method of predicting congenital bacteremia.

(AJDC 1984;138:848-850)

REFERENCES

ABSTRACT | REFERENCES

Anthony BF, Okada DM: The emergence of group B streptococci in infections of the newborn infant . Ann Rev Med 1977;;28:355-369.

Baker CJ: Group B streptococcal infections . Adv Intern Med 1980;;25:475-501.

Hemming VG, McCloskey DW, Hill HR: Pneumonia in the neonate associated with group B streptococcal septicemia . AJDC 1976;;130: 1231-1233.

Ablow RC, Driscoll SG, Effmann EL, et al: A comparison of early-onset group B streptococcal neonatal infection and the respiratory distress syndrome of the newborn . N Engl J Med 1976;;294:65-70.

Jeffery H, Mitchison R, Wigglesworth JS, et al: Early neonatal bacteraemia: Comparison of group B streptococcal, other Gram positive and Gram negative infections . Arch Dis Child 1977;; 52:683-686.

Boyle RJ, Chandler BD, Stonestreet BS, et al: Early identification of sepsis in infants with respiratory distress . Pediatrics 1978;;62:744-750.

Sherman MP, Goetzman BW, Ahlfors CE, et al: Tracheal aspiration and its clinical correlates in the diagnosis of congenital pneumonia . Pediatrics 1980;;65:258-263.

Manroe BL, Rosenfeld CR, Weinberg AG, et al: The differential leukocyte count in the assessment and outcome of early-onset neonatal group B streptococcal disease . J Pediatr 1977;; 91:632-637.

Christensen RD, Bradley PP, Rothstein G: The leukocyte left shift in clinical and experimental neonatal sepsis . J Pediatr 1981;;98:101-105.

Philip AGS: Neonatal sepsis resulting from possible amniotic fluid infection . Clin Pediatr 1982;;21:210-214.

Benuck I, David RJ: Sensitivity of published neutrophil indexes in identifying newborn infants with sepsis . J Pediatr 1983;;103:961-963.

Manroe BL, Weinberg AG, Rosenfeld CR, et al: The neonatal blood count in health and disease: I. Reference values for neutrophilic cells . J Pediatr 1979;;95:89-98.

Galen RS, Gambino SR: Beyond Normality: The Predictive Value and Efficiency of Medical Diagnoses . New York, John Wiley & Sons, Inc, 1975;, pp 10-14.

Benirschke K: Routes and types of infection in the fetus and the newborn . AJDC 1960;; 99:714-721.

Naeye RL, Dellinger WS, Blanc WA: Fetal and maternal features of antenatal bacterial infections . J Pediatr 1971;;79:733-739.

Harris H, Wirtschafter D, Cassady G: Endotracheal intubation and its relationship to bacterial colonization and systemic infection of newborn infants . Pediatrics 1976;;56:816-823.

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