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Thomas B. Newman, MD, MPH; Michael A. Kohn, MD, MPP

Arch Pediatr Adolesc Med. 2009;163(7):675-676.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Dutta et al¹ reported impressive results using universal primer 16S rRNA polymerase chain reaction (PCR) to diagnose sepsis among 242 patients in a level III neonatal intensive care unit (NICU). However, because 2 of 52 bacteremic patients (4%) had falsely negative results, DeCamp et al,² in the accompanying commentary, were unenthusiastic, concluding that "universal PCR is still not accurate enough to justify withholding antibiotic therapy in neonates being evaluated for sepsis."

We believe DeCamp and colleagues' conclusion may be too pessimistic. In the NICU setting of the study by Dutta et al, the pretest probability of sepsis was 21.5% and a negative test (likelihood ratio, 0.04) reduced the probability of sepsis to about 1.1%. One could argue that it is worth treating at least 100 patients with antibiotics for each one who really needs them; therefore, in a NICU setting . . . [Full Text of this Article]

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