Evans Rianna C, Fine Bryan R
Division of Pediatric Hospital Medicine, Department of Pediatrics, Children's Hospital of The King's Daughters, 601 Children's Lane, Norfolk, VA 23507, USA.
Hosp Pediatr. 2013 Apr;3(2):97-102. doi: 10.1542/hpeds.2012-0025.
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.
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.
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.
In certain clinical situations, the inpatient observation period for infants under evaluation for SBI may be decreased to 36 hours.
确定0至90日龄健康婴儿在评估严重细菌感染（SBI）期间采集的血液、尿液和脑脊液（CSF）培养阳性结果的检测时间（TTD）。
本研究是对0至90日龄婴儿的回顾性病历审查，这些婴儿在急诊科或住院环境中接受SBI评估时血液、尿液或CSF培养呈阳性。记录培养阳性结果的TTD、检测原因和婴儿年龄。
共审查了283份病历，涉及307份阳性培养结果。在101份血液培养阳性结果中，38%为真正的病原体，平均TTD为13.3小时；97%在≤36小时内得到鉴定。与TTD＜36小时的血液培养相比，TTD≥36小时的血液培养污染可能性高7.8倍。在192份尿液培养阳性结果中，58%为真正的病原体，平均TTD为21小时；95%在≤36小时内得到鉴定。14份CSF培养阳性结果中有50%为真正的病原体，平均TTD为28.9小时；86%在≤36小时内得到鉴定。当单独分析≤28日龄婴儿的数据时，阳性血液和尿液培养结果的TTD模式与0至90日龄所有婴儿的情况相同。
在某些临床情况下，接受SBI评估的婴儿住院观察期可缩短至36小时。
