Genetic profiling of microorganisms in culture materials from patients with neonatal sepsis

Aim: Neonatal sepsis is a clinic sendrom which has systemic signs and symptoms of infection are present and a specific agent is detected in blood culture in the first month of life. Despite the developments in the field of neonatology, it is still an important cause of morbidity and mortality. Absence of specific signs of sepsis and the fact that non-infectious clinical conditions frequently encountered in the neonatal period have similar findings makes it difficult to diagnose and start treatment early. The diagnosis of sepsis is made by evaluating the clinical and laboratory findings together. There is no perfect marker with high sensitivity and specificity in diagnosing Neonatal sepsis. Although the detection of the agent in the blood culture is the gold standard in the diagnosis of neonatal sepsis, it has low sensitivity and getting results in 24-72 hours are among its disadvantages. Molecular studies on related genes and/or pathogens in the diagnosis of neonatal sepsis have gained momentum. Recently, PCR-based methods have started to be used in addition to culture, especially in the identification of the pathogen. Pathogens can be detected directly from patient samples within a few hours with these methods. Method: In the study, reverse transcription (RT) and real-time PCR (qPCR) (RT-qPCR) targeting agent-specific genomic RNA and DNA regions were applied to nucleic acid isolates obtained from nasopharyngeal swab and peripheral blood samples. Results: Forty-five patients diagnosed with neonatal sepsis were included in the study. In our study to determine the place of molecular methods in diagnosing neonatal sepsis, RSV was detected in %55.6 of the patients. S.pneumoniae in %42.2, C.pneumoniae in %40, Rhinovirus in %37.8, Adenovirus in %35.6, Bocavirus in %28.9, L.pneumophila in %20, H. influenzae in %13.3 and M. pneumoniae were detected in %3.4 of the patients. There was no correlation in blood culture and PCR results. Conclusion: PCR analysis in the samples of infants evaluated for sepsis in the study provides limited information. The species and number of microorganisms identified in the simultaneous PCR kit used should be increased in order to properly evaluate the clinical sensitivity and positive predictive value of the PCR examination. More, well-defined prospective studies are needed. Keywords: Neonatal sepsis, Polymerase chain reaction