Multiple site blood cultures in the initial evaluation for neonatal sepsis during the first week of life

We present the first investigation that examines the usefulness of multiple site blood cultures in the initial evaluation for neonatal sepsis during the first week of life. Two sets of blood cultures (1 aerobic and 1 anaerobic bottle/set; BACTEC, NR 6A/7A) from different sites were obtained from 460 inborn infants who were evaluated for possible sepsis. From 0.5 to 1 ml of blood was inoculated into each blood culture bottle. In 18 infants the use of multiple site blood cultures yielded important information. In 8 of these neonates bacteremia was confirmed whereas in 10 cases contamination from skin flora was documented. We could identify no instances in which the delay in antibiotic therapy while the second set of blood cultures was obtained contributed to an adverse outcome. We conclude that multiple site blood cultures are useful in the initial evaluation for suspected sepsis during the first week of life.