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Related Concept Videos

Urine Studies II: Urine Culture and Sensitivity Test01:26

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Related Experiment Video

Updated: Apr 9, 2026

Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
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Revisiting time to blood culture positivity: can we decrease antibiotic exposure in the NICU?

Rachel J Graf1, Amy Edwards2,3, Moira A Crowley2,4

  • 1Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, University Hospitals, Cleveland, OH, USA. rachel.graf@uhhospitals.org.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 7, 2026
PubMed
Summary
This summary is machine-generated.

Blood culture positivity in neonatal intensive care units (NICUs) did not meet the 90% target by 24 hours, indicating empiric antibiotic duration should not be reduced. NICU-specific data is crucial for practice changes.

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Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Sepsis is a significant concern in neonatal intensive care units (NICUs).
  • Empiric antibiotic duration decisions require accurate data on pathogen detection times.
  • Early-onset (≤72h) and late-onset (>72h) sepsis have different diagnostic considerations.

Purpose of the Study:

  • To investigate the time to positivity of blood cultures in a NICU.
  • To inform decisions regarding empiric antibiotic duration for neonatal sepsis evaluations.
  • To assess the feasibility of discontinuing antibiotics at 24 hours based on positivity rates.

Main Methods:

  • Retrospective review of positive blood cultures from infants in a NICU.
  • Data collected from July 1, 2018, to July 1, 2023.
  • Analysis focused on time to positivity and bacterial growth patterns.

Main Results:

  • 264 positive blood cultures from 125 infants were analyzed.
  • Most positive cultures (86%) occurred during the late-onset sepsis period.
  • 84% of pathogenic bacterial cultures (excluding contaminants) were positive by 24 hours.

Conclusions:

  • The study did not meet the 90% positivity target by 24 hours, precluding the discontinuation of empiric antibiotics.
  • Gram-negative bacteria showed faster growth than gram-positive bacteria.
  • Individual NICU data analysis is essential before implementing changes in antibiotic stewardship practices.