Time to positivity of neonatal blood cultures
Y Kumar, M Qunibi, T J Neal, C W Yoxall
Department of
Neonatology, Liverpool Women's Hospital, Liverpool, UK
Correspondence to: Dr Kumar, Royal Cornwall Hospital, Truro TRI 3RG, Cornwall, UK y.kumar{at}rcht.swest.nhs.uk
Accepted 16 July 2001
AIM
To determine how
long it takes neonatal blood cultures to become positive.
METHODSData were
collected retrospectively on 451 positive blood cultures from babies on
a tertiary neonatal unit between January 1997 and December 1998. During
the study period, the laboratory used the BacT/Alert microbial
detection system.
RESULTSComplete
information was available on 416 blood cultures. Twelve became positive
after 72 hours, none of which were considered to be clinically
significant. Of the 404 remaining cultures, 86% were positive at 36 hours, 96% at 48 hours, and 98.5% by 60 hours. If definite bacterial
pathogens are considered alone, the time to positivity was 90% by 36 hours, 93% by 48 hours, and 98% by 60 hours. If definite and possible
bacterial pathogens are considered (coagulase negative staphylococci
taken as possible bacterial pathogens), the time to positivity was 89%
at 36 hours and 97% at 48 hours. The negative predictive value, for
isolation of any organism before 72 hours, of a negative blood culture
was 97% at 36 hours and 99% at 48 hours. The negative predictive
value for the isolation of definite bacterial pathogens only was 99.7% at 36 hours and 99.8% at 48 hours.
CONCLUSIONSA period
of 36 hours is enough to rule out sepsis in the asymptomatic neonate,
and a three day incubation period is sufficient to detect all
clinically important infections using the BacT/Alert microbial
detection system.
Keywords: blood cultures; positivity; sepsis; infection
© 2001 by Archives of Disease in Childhood
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