Polymerase chain reaction (PCR) can overcome the drawbacks of culture in diagnosis of neonatal sepsis. Many reports have shown potential benefit.
We compared microbe detection rate between 2 groups—when PCR was used along with blood culture (culture + PCR, CP) versus when culture alone was used. We also sought to describe, in CP, the causal organisms and their resistance patterns and to study duration of antibiotic therapy in CP versus culture alone groups.
We studied a prospective cohort of babies where both culture and PCR could be sent and a retrospective cohort when only culture was used; in those who required antibiotic for suspected health care–associated infection.
When PCR was used along with culture, microbes were detected in 40.3% samples, as against only 24.6% with culture alone. Gram-negative bacilli were the most common organism detected (56.5% of positive samples) followed by Candida species. Resistance was reported in only 3 of the tested gram-negative organisms. Empiric antibiotics were stopped significantly earlier in the cohort where PCR was also used as compared with when culture alone was relied upon (median duration of therapy 3 vs 7 days, respectively).
Polymerase chain reaction improves diagnostic yield in neonatal health care–associated infection and can help decrease duration of antibiotic therapy. Resistance to broad spectrum antibiotics is uncommon.