[Retrospective analysis of 1331 samples of cerebrospinal fluid in newborn XXXX with suspected infection].

@entity1 @entity548 @entity3465 @entity4008 @entity649 @entity2348 @entity693 @entity3459 @entity281
BACKGROUND: Definitive diagnosis of a @entity281 usually requires recovery of an etiologic agent from body fluids or tissues such as spinal fluid, blood and urine. Routine lumbar puncture (LP) may raise some problems in interpreting results. POPULATION AND METHODS: A retrospective analysis of 1331 samples of CSF was made. LP had been performed on 1041 neonates including 569 prematures (54.6%) as a part of the evaluation for suspected @entity2348 . RESULTS: In 50.7% of the cases, the CSF was @entity548 . The frequency of traumatic taps increased with the degree of @entity3465 , low birth weight, precocity of LP, association with @entity649 and @entity3459 factors. In addition, haemorragic taps modified biochemical and cytologic characteristics of CSF. One hundred and six (8%) CSF samples contained organisms but the diagnosis of @entity693 was certain in only 23 cases (2.2%). In the other 83 cases, CSF was thought to be contaminated, mostly by coagulase-negative staphylococci. Since both blood and CSF cultures were positive for the same bacterial organism in 18 cases, it was concluded that the LP had been useful in identifying the pathogens in only five cases. The high frequency of contaminated CSF led to overestimation of the incidence of true @entity4008 (0.57% in our study). CONCLUSIONS: The low incidence of @entity693 in neonates, the risk of having an haemorragic tap associated with the possibility of clinical aggravation during LP and the fact that the same pathogen is frequently (78.2% of cases) identified in blood cultures suggest that the immediate and routine LP is of less value than expected in @entity1 suspected to be infected. LP could be postponed when the neonate presents with a @entity649 and/or a precarious haemodynamic state.
