Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPSTRANIERI, InesKANUNFRE, Kelly AparecidaRODRIGUES, Jonatas CristianYAMAMOTO, LidiaNADAF, Maria Isabel ValdomirPALMEIRA, PatriciaOKAY, Thelma Suely2019-01-172019-01-172018REVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO, v.60, article ID UNSP e61, 10p, 20180036-4665https://observatorio.fm.usp.br/handle/OPI/30012Bacterial sepsis remains a major cause of mortality and blood cultures are the gold standard of laboratory diagnosis even though they lack sensitivity in neonates. Culture-negative sepsis, also known as clinical sepsis, has long been considered a diagnosis in neonatal intensive care units because, as well as culture-positive infants, culture-negative neonates have worse prognosis in comparison with non-infected ones. Quantitative amplifications are used to detect bacterial infections in neonates but results are considered only in a qualitative way (positive or negative). The aim of the present study was to determine and compare bacterial load levels in blood culture-positive and culture-negative neonatal sepsis. Seventy neonates with clinical and laboratory evidence of infection admitted at three neonatal intensive care units were classified as blood culture-positive or culture-negative. Blood samples obtained at the same time of blood cultures had bacterial load levels assessed through a 16S rDNA qPCR. Blood cultures were positive in 29 cases (41.4%) and qPCR in 64 (91.4%). In the 29 culture-positive cases, 100% were also positive by qPCR, while in the 41 culture-negative cases, 35 (85.4%) were positive by qPCR. Bacterial load levels were in general < 50 CFU/mL, but were significantly higher in culture-positive cases (Mann-Whitney, p = 0.013). although clinical and laboratory findings were similar, excepting for deaths. In conclusion, the present study has shown that blood culture-negative neonates have lower bacteria load levels in their bloodstream when compared to blood culture-positive infants.engopenAccessBlood cultureCulture-negative neonatal sepsisNeonatal blood stream infectionReal Time PCR16S rDNApolymerase-chain-reactionreal-time pcrstream infectionsmolecular assaysdiagnosischildreninfantsbirthgenevolumearticleCopyright INST MEDICINA TROPICAL SAO PAULO10.1590/S1678-9946201860061Tropical Medicine1678-9946