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PO-0533 Neonatal Blood Culture: Survey Of Blood Culture Bottle Use In Uk Neonatal Units
  1. J Egyepong1,
  2. D Bell2,
  3. J Amenu3
  1. 1Neonatal Intensive Care Unit, Luton and Dunstable University Hospital, Luton, UK
  2. 2Medical Student, University College London, London, UK
  3. 3Paediatric Intensive Care Unit, Kings College Hospital, London, UK

Abstract

Introduction Neonatal sepsis carries a high morbidity and mortality. Blood culture is the current ‘gold standard’ investigation. The results obtained is of vital diagnostic, therapeutic, surveillance and prognostic importance. Traditionally in the past, paired samples were used, however with the decrease in anaerobic infections, from the 1980s and current Health Protection Agency (UK) figures on bacteria causing neonatal sepsis, this practice is changing with calls to abandon anaerobic blood cultures.

Objectives Survey of all Neonatal units in UK to determine-

  • Whether single (aerobic) or paired (aerobic and anaerobic) bottles are used.

  • If single, whether there are special occasions when anaerobic cultures are included.

  • Any variations in practice according to the level of care and in the different nations of the UK.

Methods

  • Read Literature on neonatal blood culture bottle use to inform questionnaire design.

  • Telephone survey Feb–March 2014.

  • Interviewee: medical staff or nurse-in-charge only.

Results

  • All 204 neonatal units were surveyed.

  • Number using single = 197/204 (96.1%); paired =8/204(3.9%).

  • 11/197 using single, occationally use paired.

  • Paired: England 3/170 (1.8%); Scotland 2/15 (13.4%); Wales 0/12 and NI 3/7 (42%) (Figure 1).

  • Level of care: NICU 2/55(3.6%), LNU 5/90(5.6%) and SCBU 1/59(1.7%) (Figure 2).

Conclusions

  • There is general uniformity in the type of bottle used- single aerobic bottles.

  • As the ‘gold standard’ investigation for neonatal sepsis, it needs to follow evidence-based traditions to improve yield.

  • There is a need to be aware of when an anaerobic bottle should be included rather than a ‘box-standard’ approach.

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