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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2023; 83(11): 1382-1390
DOI: 10.1055/a-2091-0856
GebFra Science
Original Article

Possible Rates of Detection of Neonatal Sepsis Pathogens in the Context of Microbiological Diagnostics in Mothers – Real World Data

Article in several languages: English | deutsch
Raffael Kuld
1   Klinik für Frauenheilkunde und Geburtshilfe, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany (Ringgold ID: RIN15050)
2   Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
,
Alexander Krauth
3   Klinik für Kinderheilkunde, Franz-Lust-Kinderklinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany (Ringgold ID: RIN15050)
,
Joachim Kühr
3   Klinik für Kinderheilkunde, Franz-Lust-Kinderklinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany (Ringgold ID: RIN15050)
,
Janine Krämer
1   Klinik für Frauenheilkunde und Geburtshilfe, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany (Ringgold ID: RIN15050)
,
Ralf Dittrich
2   Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
4   Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
,
Lothar Häberle
2   Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
4   Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
,
Andreas Müller
1   Klinik für Frauenheilkunde und Geburtshilfe, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany (Ringgold ID: RIN15050)
2   Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Abstract

Objective

The aim of this study was to identify the rate of detection of neonatal sepsis pathogens in maternal microbiological smears.

Study Design

This is a retrospective study conducted at a Level 1 perinatal center in the context of routine care from 2014 to 2019. For all premature infants and neonates with neonatal sepsis, the neonatal and maternal microbiological findings were examined to see if there was a match.

Results

During the study period, a total of 948 premature or newborn infants were identified as having a neonatal infection. Among all of the premature or newborn infants, 209 (22%) met the diagnostic criteria for neonatal sepsis; of these, 157 were premature births and 52 were full-term births. We evaluated the microbiological findings for these 209 mother and child pairs. No pathogens were detected in 27 out of 157 mothers of premature infants (17.1%) and in 31 out of 52 mothers of full-term infants (59.6%). In the premature infant group there were pairs with matching pathogens in 30 out of 130 cases (23.1%, 95% CI: 16.1–31.3), and in the full-term infant group there was a match in 4 out of 21 cases (19%, 95% CI: 5.4–41.9). The number needed to test to have a 90% probability of success for pathogen detection varies between 9 and 11 in the most favorable case and 26 and 32 in the least favorable case, depending on the evaluation method.

Conclusion

In cases of neonatal sepsis, the sepsis-causing pathogen was successfully detected through prior analysis of a maternal smear in 7% of full-term infants and in 19% of premature infants. The number needed to test was relatively high in all groups. The value of maternal smears for identifying neonatal sepsis-causing pathogens needs to be critically questioned.

Keywords

bacterial infection - infections - premature birth - pregnancy - normal birth


Publication History

Received: 13 February 2023

Accepted after revision: 07 May 2023

Article published online:
21 June 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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