Treatment of Neonatal Sepsis with Immune Globulin

To the Editor: The International Neonatal Immunotherapy Study (INIS) Collaborative Group (Sept. 29 issue) 1 reports that therapy with intravenous immune globulin was not associated with decreased mortality in neonatal sepsis. However, many patients who were included in this study had cultures growing coagulase-negative staphylococci, which are usually less pathogenic and are associated with a better outcome than are coagulase-positive staphylococci. In addition, such cultures often contain contaminants from skin. Since severe sepsis was not strictly defined in this study, many patients could have conditions that were falsely diagnosed as sepsis, with relatively mild symptoms and a false positive blood culture. . . .