How useful is routine amniotic fluid and neonatal surface swab microbiology at Caesarean section?
BACKGROUND
Our aim was to evaluate the clinical impact of routine amniotic fluid and neonatal surface swab microbiology at Caesarean section.


METHODS
Microbiology data from 1 537 neonates delivered by Caesarean section were analysed in the light of clinical outcome.


RESULTS
1 340 (87%) neonates had non-pathogenic bacteria or negative culture results from both amniotic fluid and surface swab samples. Of the 197 (13%) neonates with pathogenic bacteria, 22 (1.4%) were diagnosed with infection, but only in 6 (0.4%) were the bacteria presumed to be responsible for the infection. Amniotic fluid and surface swab culture had sensitivities of 54% and 35%, and positive predictive values of 14% and 17%, respectively, for detecting a neonate at risk of infection.


CONCLUSIONS
Amniotic fluid and neonatal surface swab microbiology at Caesarean section contributes little if anything to postnatal management and can be safely dropped from operative routine.
Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.
A
A
Zbinden
R
R
Zbinden
G
G
Natalucci
R
R
Zimmermann
H U
HU
Bucher
A
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Krafft
D000653:Amniotic Fluid / Q000382:microbiology*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000151:congenital* / Q000175:diagnosis*; D001431:Bacteriological Techniques; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012867:Skin / Q000382:microbiology*; D013290:Streptococcal Infections / Q000151:congenital / Q000175:diagnosis; D013292:Streptococcus agalactiae; D013557:Switzerland; D019564:Unnecessary Procedures