Lumbar Puncture in Neonates with Sepsis

Infections are one of the main causes of death during childhood. Epidemiologic studies in Iran showed that the incidence of neonatal sepsis was 1.8% in 1995. Moreover, the incidence of neonatal meningitis is 0.2 to 0.4 in per 1,000 live births. The aim of this study was to determine the necessity of lumbar puncture (LP) in early neonatal sepsis. In a retrospective study, after obtaining ethical approval, we evaluated the records of 1,100 neonates, younger than 7 days, who were admitted to the hospital between 2001 and 2007. They were suspected of sepsis and thus, LP was performed. Statistical analyses were performed by SPSS version 16. Nominal variables were compared using Chi-square or Fisher’s exact test. Other parametric and non-parametric tests were used as required. In our study, 1,100 neonates, suspected of sepsis, were evaluated. Of all neonates, 28.3% and 71.7% were older and younger than 3 days, respectively. Male-to-female ratio was 1:5 in 115 neonates. Sepsis was confirmed by positive blood culture, and 21 neonates (2.1%) had positive cerebrospinal fluid (CSF), which was significantly associated with blood culture results. There was a significant relationship between blood culture and CSF culture results. However, regarding the low incidence of positive CSF, LP should be performed for each case, based on clinical manifestations and clinical opinion.