Abstract Introduction: Early Onset Sepsis (EOS) remains a leading cause of neonatal morbidity and mortality, with peripheral venous blood culture (PVBC) serving as the diagnostic gold standard. However, delays in culture positivity and challenges in obtaining adequate neonatal blood volume limit its reliability. The utility of umbilical cord blood culture (UCBC) as an alternative remains underexplored. This study aimed to evaluate and compare the diagnostic performance of PVBC and UCBC for EOS. Methodology: This prospective observational study was conducted at a tertiary care center on 128 high-risk neonates with two or more risk factors. Blood samples were collected from both the umbilical cord and peripheral vein for culture. A sepsis screen was performed for diagnosis of neonatal sepsis. Results: The most frequent risk factor for neonatal sepsis was premature rupture of membranes (35.16%), low birth weight (20.31%) and meconium-stained liquor (19.53%). The most commonly isolated organisms were Staphylococcus aureus (Methicillin resistant S. aureus ), followed by Klebsiella pneumoniae , Staphylococcus hominis , and Staphylococcus schleiferi . Compared with PVBC, UCBC demonstrated a sensitivity of 81.40%, specificity of 57.65%, positive predictive value of 49.29%, negative predictive value of 85.96%, and overall diagnostic accuracy of 65.62%. Cohen’s kappa showed a fair agreement (κ =0.34) between the methods. Conclusion: UCBC appears simple convenient method for diagnosing EOS, with microbial yields comparable to PVBC. It may help reduce phlebotomy-related blood loss and facilitate early detection. However, the limited sample size and single-center design restrict generalizability. Large multicenter studies are required to confirm its diagnostic validity and optimize strategies to reduce contamination.
Barabde et al. (Thu,) studied this question.
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