Role of multiple site blood cultures to document the clearance of bacteremia in neonates

Abstract

Objective: To evaluate the usefulness of two-site blood cultures for the documentation of bacterial clearance during initial treatment of culture proven neonatal sepsis.Design/methods: Clinical data were prospectively collected for 216 neonates who had blood cultures drawn for evaluation of possible sepsis. A positive diagnostic blood culture was followed by repeat blood cultures from two different peripheral sites after initiation of antimicrobial therapy.Results: Follow-up two-site cultures were drawn on 25 occasions at a median interval of 3 days after start of antimicrobial therapy for cultureproven sepsis in 15 neonates. On 12 occasions, follow-up blood cultures were both negative. On eight occasions, follow-up blood cultures grew the same organisms from both sites. However, follow-up two-site cultures on five occasions in four of the 15 infants grew organisms from one site but not the second site.Conclusions: Two-site blood cultures seem necessary to document bacterial clearance in response to antimicrobial therapy for cultureproven sepsis, and may help determine the appropriate duration of antimicrobial therapy by reducing false-negative results.

Identification of the most common pathogenic bacteria in patients with suspected sepsis by multiplex PCR

“…Conventional diagnostic methods for BSIs require several days to complete, and both false positive [15,16] and false negative results [17,18] have been reported. Delayed diagnosis correlates strongly with the high mortality of BSIs [19,20].…”

Serial C reactive protein values predict sensitivity of organisms to empirical antibiotics in neonates: a nested case–control study

“…Laboratory reporting of antibiotic sensitivity may take 48 h or more. Blood culture may at times be falsely negative, depriving the clinician of sensitivity data 4 5. Blood culture facilities are not ubiquitous in many low/middle-income countries 6.…”

Clinical value of repeat blood cultures in neonatal patients receiving antibiotic treatment

“…Cultures repeated on day 5 were significantly more likely to reveal a new pathogen than those repeated on days 1-4 (P < 0.01). There was no statistically significant difference between day 6 and any other day (1)(2)(3)(4)(5). CONS was significantly more likely in cultures repeated on day 6 compared with days 1 or 2 (P < 0.05).…”

“…Repeat blood culturing is more common in neonates than in patients of other age groups, partly due to the high morbidity and mortality rates of infection in neonates, 1 and partly due to inconclusive culture findings resulting from the small volumes of blood sampled. [2][3][4] A major drawback of repeat blood culturing is the cost of such testing. In addition, the contamination rate increases with each test performed, thereby creating diagnostic confusion and prolonging hospitalization.…”