title: The utility of tracheal aspirate cultures in the immediate neonatal period.
abstract: OBJECTIVE
  Determine the contemporary incidence of pathogenic tracheal aspirate (TA) cultures when obtained within 12 h of birth, and to associate TA culture results with specific clinical conditions that increase the risk of infection.
  
  
  METHODS
  A retrospective study over a 6-month period of admissions to a single outborn neonatal intensive care unit when a TA sample was collected within 12 h of birth (n=139).
  
  
  RESULTS
  In total, 9 of 139 (6.5%) TA cultures were positive for pathogenic bacterial growth. Maternal fever (relative risk (RR)=7.7, P<0.04) and clinical chorioamnionitis (RR=6.4, P<0.02) were significantly associated with pathogenic TA culture results. Infants with a pathogenic TA culture had lower white blood cell counts (7,500 vs 13,900 mm(-3), P<0.05) when compared with infants with a negative culture. In eight of the nine patients with pathogenic cultures, either the mother or the infant received antibiotics before TA sample collection.
  
  
  CONCLUSIONS
  Early TA culture is a helpful tool in diagnosing pneumonia, especially in certain clinical scenarios, including maternal fever, clinical chorioamnionitis and leukopenia. Administration of antibiotics before sample collection does not seem to preclude culture growth.
authors.affiliation: Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, MO 63104, USA. boothgr@slu.edu
authors.forename: G R
authors.initials: GR
authors.lastname: Booth
authors.forename: M
authors.initials: M
authors.lastname: Al-Hosni
authors.forename: A
authors.initials: A
authors.lastname: Ali
authors.forename: W J
authors.initials: WJ
authors.lastname: Keenan