Comparison of BacT/Alert microbial detection system with conventional blood culture method in neonatal sepsis

Abstract

Blood culture remains the gold standard for diagnosing neonatal septicemia. Although automated continuous monitoring blood culture systems have generally been shown to be superior to conventional manual systems, there are few data relating to their use specifically in neonates. The aim of this study was to compare the manual method of blood culture with an automated BacT/Alert 3D system for detection of neonatal septicemia in terms of rate of recovery of pathogens and time to positivity. One hundred and one matched pairs of blood culture specimens from patients on a neonatal intensive care unit were evaluated by the two methods. The yield of significant pathogens with the BacT/Alert 3D system was 45.5%, compared with 18.8% with the manual method (P < 0.0001). Moreover, streptococci, which are important neonatal pathogens, were detected exclusively with the automated system. The median time to positivity with the automated system was 11.5 h, compared with 24 h for the manual system. The BacT/Alert 3D system offers more sensitive and rapid detection of neonatal septicemia than a manual blood culture method. The clinical benefits of this may justify the additional cost of automated blood culture systems in developing countries where manual systems currently remain commonplace.

Keywords

Neonatal septicemia - automated systems - BacT Alert 3D system - manual/conventional blood culture