Aim To prospectively assess staff prediction of culture positivity, clinical signs noted and suggested duration of antibiotic therapy required at the time of septic screen in premature infants suspected of having late onset sepsis.

Methods This was a prospective study involving anonymous staff questionnaires filled out by both nursing and medical staff at the time of septic screens performed for suspected late onset sepsis in the neonatal intensive care unit (NICU) of Rotunda Maternity Hospital, Dublin from October 2009 to 2010. Eligibility criteria was defined as premature infants (< 34 weeks gestation) and > 5 days old undergoing septic work up for suspicion of infection. Prospective review of all blood, urine and CSF cultures obtained from the neonates. Staff opinion on the likelihood of positive BC was correlated with laboratory results and treatment course.

Results Total of 60 surveys collected in the twelve month period. Information is available from 56 septic work ups carried out on 37 infants during twelve month period on infants who fulfilled the criteria. Doctors correctly guessed if the infant was septic or not at the time of work up 58.3% compared to 56.3 % of nursing staff. There was no stasticial significance between C-reactive protein, white cell or neutrophils counts between positive and negative cultures.

Conclusion Experienced doctors and nurses were unable to accurately predict which neonate would have a positive culture. This highlights the difficulty in the NICU setting of judging correctly who is septic in very low birth weight infants.