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Z Geburtshilfe Neonatol 2011; 215(05): 205-208
DOI: 10.1055/s-0031-1291211
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

How Useful is Routine Amniotic Fluid and Neonatal Surface Swab Microbiology at Caesarean Section?

Wie nützlich ist die anlässlich einer Sectio caesarea routinemässig gewonnene Kultur aus Fruchtwasser und Kindsabstrich?
A. Zbinden
1   Institute of Medical Microbiology, University of Zurich, Switzerland
,
R. Zbinden
1   Institute of Medical Microbiology, University of Zurich, Switzerland
,
G. Natalucci
2   Department of Neonatology, University Hospital Zurich, Switzerland
,
R. Zimmermann
3   Department of Obstetrics, University Hospital Zurich, Switzerland
,
H. U. Bucher
2   Department of Neonatology, University Hospital Zurich, Switzerland
,
A. Krafft
3   Department of Obstetrics, University Hospital Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

received 29 June 2011

accepted after revision 30 August 2011

Publication Date:
25 October 2011 (online)

Also available at
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Abstract

Background:

Our aim was to evaluate the clinical impact of routine amniotic fluid and neonatal surface swab microbiology at Caesarean section.

Materials and Methods:

Microbiology data from 1 537 neonates delivered by Caesarean section were analysed in the light of clinical outcome.

Results:

1 340 (87%) neonates had non-pathogenic bacteria or negative culture results from both amniotic fluid and surface swab samples. Of the 197 (13%) neonates with pathogenic bacteria, 22 (1.4%) were diagnosed with infection, but only in 6 (0.4%) were the bacteria presumed to be responsible for the infection. Amniotic fluid and surface swab culture had sensitivities of 54% and 35%, and positive predictive values of 14% and 17%, respectively, for detecting a neonate at risk of infection.

Conclusion:

Amniotic fluid and neonatal surface swab microbiology at Caesarean section contributes little if anything to postnatal management and can be safely dropped from operative routine.

Zusammenfassung

Hintergrund:

Das Ziel dieser Studie war, die klinische Wertigkeit von routinemässig abge­nommenen mikrobiologischen Fruchtwasserproben und Kindsabstrichen anlässlich einer Sectio zu prüfen.

Methodik:

Mikrobiologische Daten von 1537 per Kaiserschnitt geborenen Kindern wurden im Zusammenhang mit dem klinischen neonatalen Verlauf ausgewertet.

Ergebnisse:

1340 (87%) Neugeborene wiesen sowohl im Fruchtwasser als auch im Kindsabstrich nicht-pathogene Keime oder negative Kulturresultate auf. Von 197 (13%) Neugeborenen mit pathogener Keimbesiedelung wurde bei 22 (1.4%) eine Infektion diagnostiziert, wobei in 6 Fällen (0.4%) die nachgewiesenen Bakterien als ursächlich angesehen wurden. Fruchtwasserkulturen wiesen eine Sensitivität von 54%, Kindsabstriche eine Sensitivität von 35% auf. Der positive prädiktive Wert für die Entdeckung eines Neugeborenen mit einem Risiko für eine Infektion lag bei 14% für die Fruchtwasserkultur und bei 17% für den Kindsabstrich.

Schlussfolgerung:

Fruchtwasserkulturen und Kindsabstriche, welche anlässlich eines Kaiserschnittes gewonnen werden, tragen nur wenig zum postpartalen Management des Neugebo­renen bei und müssen nicht routinemässig durchgeführt werden.

Key words

amniotic fluid - surface swab - caesarean section - microbiology

Schlüsselwörter

Fruchtwasser - Kindsabstrich - Kaiserschnitt - Mikrobiologie
 

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