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Published on: July 9, 2012
Time to detection of bacterial cultures in infants aged 0 to 90 days
1Division of Pediatric Hospital Medicine, Department of Pediatrics, Children's Hospital of The King's Daughters, 601 Children's Lane, Norfolk, VA 23507, USA. rianna.evans@chkd.org
Insights
This study found that most serious bacterial infections in infants aged 0-90 days are detected within 36 hours. This suggests that the inpatient observation period for infants evaluated for serious bacterial infections may be shortened to 36 hours.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Microbiology
Background:
- Serious bacterial infections (SBI) are a significant concern in infants.
- Accurate and timely diagnosis is crucial for effective treatment and management.
- Current diagnostic protocols involve monitoring culture results, with time to detection (TTD) being a key factor.
Purpose of the Study:
- To determine the time to detection (TTD) of positive results for blood, urine, and cerebrospinal fluid (CSF) cultures.
- To evaluate TTD in infants aged 0 to 90 days undergoing evaluation for SBI.
- To inform potential adjustments to inpatient observation periods based on culture TTD.
Main Methods:
- Retrospective chart review of infants aged 0 to 90 days.
- Inclusion criteria: positive blood, urine, or CSF cultures during SBI evaluation.
- Data collected: TTD, reason for testing, infant age.
Main Results:
- 307 positive culture results from 283 charts were analyzed.
- Blood cultures: 38% true pathogens, mean TTD 13.3 hours; 97% identified within 36 hours.
- Urine cultures: 58% true pathogens, mean TTD 21 hours; 95% identified within 36 hours.
- CSF cultures: 50% true pathogens, mean TTD 28.9 hours; 86% identified within 36 hours.
- Cultures with TTD ≥ 36 hours were 7.8 times more likely to be contaminants.
Conclusions:
- The majority of true pathogens in blood, urine, and CSF cultures are detected within 36 hours.
- TTD patterns were consistent for infants ≤ 28 days and 0-90 days.
- Inpatient observation for infants evaluated for SBI may be safely reduced to 36 hours in select cases.
Objective:
To determine the time to detection (TTD) of positive results on blood, urine, and cerebrospinal fluid (CSF) cultures taken during the evaluation for serious bacterial infection (SBI) in otherwise healthy infants aged 0 to 90 days.
Methods:
This study was a retrospective chart review of infants aged 0 to 90 days with positive blood, urine, or CSF cultures drawn during evaluation for SBI in the emergency department or inpatient setting. The TTD of positive culture results, reason for testing, and age of the infant were recorded.
Results:
A total of 283 charts were reviewed related to 307 positive culture results. Of the 101 positive results on blood culture, 38% were true pathogens with a mean TTD of 13.3 hours; 97% were identified in < or = 36 hours. Blood cultures with TTD > or = 36 hours were 7.8 times more likely to be contaminants compared with those with TTD < 36 hours. Of 192 positive results on urine culture, 58% were true pathogens with a mean TTD of 21 hours; 95% were identified in < or = 36 hours. Fifty percent of 14 positive CSF culture results were true pathogens with a mean TTD of 28.9 hours; 86% were identified in < or = 36 hours. When data for infants < or = 28 days of age were analyzed separately, TTD followed the same patterns for positive blood and urine culture results as seen in all infants aged 0 to 90 days.
Conclusions:
In certain clinical situations, the inpatient observation period for infants under evaluation for SBI may be decreased to 36 hours.
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