Abstract
To determine the frequency of neonatal anaerobic bacteremia in clinically septic infants we did a 10 month prospective study employing a technique applicable in a clinical bacteriology laboratory. Specimens of 0.5-1.0 ml of blood were introduced into pre-reduced anaerobically sterilized culture medium containing 50 ml Trypricsse soy broth with CO2, sucrose and .025-.05% SPS. Cultures were subcultured at 24 hrs. and processed by a laboratory using techniques recommended by the Center for Disease Control. Special care was taken to avoid aerating the specimen or the bottle. 194 specimens from two tertiary neonatal centers were cultured. Gestational ages varied from 28 to 42 weeks. Longest hospital stay was 60 days. 8% of all cultures were positive. Two (1%) grew anaerobes.
A previous study employed research level techniques and 26% of positive cultures were anaerobes. Because of very much lower yield from techniques presently available to clinical bacteriology laboratories, we doubt the value of routinely culturing for anaerobes in neonates. We suggest that when there is reason to suspect unresponsive anaerobic infection a specialized laboratory be used to process a repeat blood specimen before a change in therapy. Since B. fragilis is practically the only anaerobe resistant to combined penicillin and aminoglycocide treatment, the most logical strategy in managing sepsis unresponsive to routine measures is to add chloramphenicol or carbenicillin to the regimen.
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Marchick, N., Modanjou, H., Greene, G. et al. ANAEROBIC BACTEREMIA IN THE NEONATE. Pediatr Res 11, 502 (1977). https://doi.org/10.1203/00006450-197704000-00796
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DOI: https://doi.org/10.1203/00006450-197704000-00796
