So tests need to be done so what test do you do so I mean first before getting the test we have to review the maternal history so we look at the risk factors for infection from the mom so did she have Group B Strep was there any leak in the meiotic fluid for a prolonged period of time which we call prolonged rupture of membranes did what kind of centers the baby has and how long has it been going on for and then we do a comprehensive physical exam and based on those we start doing the diagnostic tests okay so I can go ahead and yes we’re gonna actually look at some of these exams and tests specifically starting with blood culture so blood tests from the beginning okay so the blood culture is the gold standard for diagnosing sepsis so for establishing the diagnosis of sepsis you have to have a positive blood culture so you’re gonna be isolating an organism from the blood most of the times it’s the bacteria sometimes we also have other causes of neonatal sepsis would be less likely would be viruses or fungal infections but usually we send for a bacterial blood culture okay now the sensitivity of the blood culture is only ninety percent so in some cases we’re not able to isolate an organism from the blood culture okay but if we have a high index of suspicion for sepsis given the baby’s symptoms and other labs sometimes we do treat babies for sepsis even if we don’t get a positive blood culture because as I mentioned the sensitivity is only ninety percent and remember with these kids when we get those blood cultures and we’re only getting one CC at a time when adults we get much a bigger ball right we can’t get so much blood from the baby because they’re small their blood volume is smaller so that causes us to not get positive cultures and the other thing is sometimes these mother’s the mothers of those babies are exposed to antibiotics they receive antibiotics so that could make the blood culture sterile so it might not grow bacteria you