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Journal of Biological Sciences
Year: 2009  |  Volume: 9  |  Issue: 6  |  Page No.: 533 - 540

Diagnosis of Neonatal Bacterial Sepsis by Polymerase Chain Reaction

Amany E. Elwan and Wahiba A. Zarouk    

Abstract: The aim of this study is to find out a faster way with considerable sensitivity and specificity using a Polymerase Chain Reaction (PCR) for detecting bacterial DNA encoding 16S RNA. A broad range PCR without preincubation was compared to conventional diagnostic work up for clinical sepsis, including blood culture, for early determination of bacterial sepsis in 75 neonates with suspected neonatal sepsis. Also, the relationship between clinical signs and laboratory parameters were explored. According to blood culture results patients were classified into blood culture positive and negative groups. Blood culture positive group were 39 newborns of them 36 had PCR positive and 26 had sepsis screen positive. Blood culture negative group were 34 newborns of them 4 had PCR positive and 7 had sepsis screen positive. Compared to blood culture sepsis screen showed sensitivity 66.6%, specificity 79.4%, positive 78.7% and negative predictive value 67.5% in diagnosis of neonatal sepsis while PCR compared to blood culture showed sensitivity of 92.3%, specificity of 88.2%, positive predictive value 90% and negative predictive value 91%. Two patients were excluded from the study as their blood culture showed Candida albicans. With results available within 4 h, PCR had more sensitivity and specificity than sepsis screen in diagnosis of neonatal sepsis. PCR has potential for early detection of bacterial DNA encoding 16S RNA but this needs further development and improvement. Blood culture is still irreplaceable at present, since pure isolates are essential for antimicrobial drug susceptibility testing.

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