Time to positivity of blood cultures in a level IV NICU varies based on organism category and population subgroups: is a 36-hour rule out safe?

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发表日期：

2024年6月20日

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Yo Nishihara,
Christine E. MacBrayne,
Andrea Prinzi,
Kelly Pearce,
Diane Melara,
Blair W. Weikel,
Jeanne Zenge,
Theresa Grover,
Sarah K. Parker

摘要

Background

Time to positivity (TTP) of blood cultures and organism characteristics may be different in a Level IV NICU population.

Methods

Retrospective study of 309 Level IV NICU positive blood cultures between January 2012 to December 2018 describing TTP and organism characteristics.

Results

Median TTP [IQR] was 21.1 [14.3, 25.2] hours, with 91.2% positive at 36 h, and 96.1% positive at 48 h. Gram negative definite pathogens had the shortest TTP (13.0 [11.4, 15.4] hours) compared to gram positive definite pathogens (16.3 [13.0, 22.4] hours). TTP for treated gram positive commensal organisms (22.3 [20.1, 30.4] hours) and those considered contaminants (23.6 [21.4, 26.0] hours), was significantly longer than both gram positive and negative definite pathogens.

Conclusion

When antimicrobials are initiated due to concern for bacteremia and blood cultures have not identified a causative pathogen at 36 h, antimicrobials may be safely discontinued in the majority of Level IV NICU patients.