Affiliation:
1. University of Colorado
2. Childrens Hospital Colorado
3. Children's Hospital Colorado
4. Children's Hospital Colorado and University of Colorado
Abstract
Abstract
Background:
Antibiotics are frequently prescribed in the NICU, with increasing concern for antimicrobial resistance. Time to positivity (TTP) of positive cultures can support earlier antimicrobial cessation.
Methods:
Retrospective cohort study all positive blood cultures at a Level IV NICU. TTP calculated from date/time collection to when first growth was reported.
Results:
Of 309 positive cultures from 268 infants, median TTP [IQR] was 21.1 [14.3, 25.2] hours, with 91.2% positive at 36 hours, and 96.1% positive at 48 hours. 77 gram positive pathogens (24.9%), 60 gram negative pathogens (19.4%), and 169 gram positive commensals identified, with 124 (40.1%) considered a contaminant. Sub-group analysis identified different organism characteristics. Death within 4 weeks of positivity recorded in 9.5%.
Conclusion:
Majority of gram positive and negative pathogens were identified within 36h of blood culture collection. When antimicrobials are started for concern for bacteremia, 36 hours may be sufficient in a Level IV NICU population.
Publisher
Research Square Platform LLC