Diagnostic sensitivity of serial heelstick blood cultures in neonatal sepsis

The diagnosis of sepsis in the newborn is dependent on the recovery of bacterial organisms from the bloodstream. However, single blood culture results are often negative for the growth of organisms. The literature suggests that serial cultures might identify pathogens that are often missed when only a single culture is drawn. A heelstick blood culture method has been shown effective in identifying pathogenic organisms. This method would allow the clinician to draw serial cultures with less difficulty and minimal trauma to the infant. The purpose of this study was to determine whether serial heelstick blood cultures improved sensitivity to pathogenic organisms. An initial venous culture was drawn followed by three heelstick cultures with 15-minute intervals between each draw. All venous cultures were negative for the growth of an organism. Only one heelstick culture yielded a positive result which was felt to be a contaminant since the organism was not reported on the venous or other heelstick cultures. Therefore, continued research with a larger samiple size is needed to determine whether serial heelstick blood cultures will indeed yield a higher incidence of pathogenic organisms than a single venous culture.