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Original Article
  |     |   J Korean Soc Neonatol._18_2_240_247.pdf
J Korean Soc Neonatol. November;18(2):240-247.
Published online 2011 November 25   doi: https://doi.org/10.5385/jksn.2011.18.2.240
Copyright ⓒ 2011 The Korean Society of Neonatology Neonatal Medicine
Effective Ways of Performing Surveillance Surface Cultures in Extremely Low Birth Weight Infants
Juyoung Lee, M.D., Ee Kyung Kim, M.D., Ph.D., Jin A Lee, M.D., Chang Won Choi, M.D., Han Suk Kim, M.D., Beyong Il Kim, M.D. and Jung Hwan Choi, M.D.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Ee Kyung Kim, M.D., Ph.D. , Tel: +82-2-2072-3628 , Fax: +82-2-743-3455 , Email: kimek@snu.ac.kr
Purpose: The rationale for skin surface cultures is that bacterial colonization precedes infection and, as a result, that identification of a potential pathogen is predictive of later systemic infection in preterm infants. We aimed to analyze results of surveillance surface cultures in extremely low birth weight (ELBW) infants and seek for effective ways of performing surveillance surface cultures. Methods: We analyzed the surveillance surface cultures of 113 ELBW infants over a 4-year period. Surveillance cultures were obtained routinely from five sites: axilla, external ear canal, nasopharynx, throat (or tracheal aspirate if intubated) and anus. Each surface culture obtained during the 13 days, prior to the date of the blood culture, was compared with the blood culture obtained when sepsis was suspected. The sensitivity, specificity and positive predictive value (PPV) of the surveillance cultures were calculated among 1894 blood-surface culture pairs by surface sites, recovered organisms and interval between surveillance samples and blood cultures. Results: The overall sensitivity, specificity and PPV of surface cultures were 45.9, 22.4 and 6.8%, respectively. The PPV was highest for the throat/tracheal cultures (11.0%) and lowest for the anal cultures (2.3%). As the time of culturing progressed toward the day of blood culturing, the sensitivity and specificity of the surface cultures significantly increased. Only axillary and throat/tracheal cultures were useful in predicting the microorganisms causing sepsis. Conclusion: Surface cultures could help to predict sepsis pathogens and infection surveillance in preterm infants could be continued with a reduced number of cultured sites focusing on the axilla and throat/trachea.
Keywords: Extremely low birth weight infant, Neonatal intensive care, Infection control, Culture, Surveillance
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