Manju Yadav
King George�s Medical University, India
Posters & Accepted Abstracts: Pediat Therapeut
Introduction: The diagnosis of pneumonia soon after birth is difficult. Blood culture is often negative mainly due to antibiotics given to the mother. Since antibiotics take longer to reach the lung fluid of the neonate the chances of a tracheal aspirate being positive on gram stain are higher. Objectives: To determine the diagnostic efficacy of gram stain of tracheal aspirate in pneumonia soon after birth. Study Design: Evaluation of a diagnostic test. Consecutive neonates admitted within 8 hours of birth with respiratory distress and having a risk factor for infection were included in the study. Neonates intubated for more than half an hour or having major congenital abnormalities were excluded. Sepsis screen, blood culture, tracheal aspirate and X-ray chest were done at admission. Gold standard for diagnosis of pneumonia was a compatible clinical picture plus either (i) a positive blood culture or (ii) a combination of any two of the three: maternal risk factors for sepsis, positive sepsis screen and suggestive X-ray chest. Results: Of the 148 neonates enrolled, 70 had pneumonia of which 10 had a positive blood culture. Tracheal aspirate was positive in 40 neonates with pneumonia and 17 with no pneumonia. The sensitivity and specificity of tracheal aspirate were 57.1% and 78.2% respectively. The positive and negative predictive values were 70.2 % and 85.9 %. Conclusions: Tracheal aspirate gram stain is a simple and quick diagnostic test in the evaluation of neonates with pneumonia soon after birth as compared to blood culture.
Email: drmanjuyadav08@gmail.com
