Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
Division of Neonatology, Children's National Hospital, Washington, DC, USA.
J Perinatol. 2024 Dec;44(12):1800-1804. doi: 10.1038/s41372-024-02120-0. Epub 2024 Sep 28.
To evaluate blood culture sample volumes, identify factors linked to insufficient samples, and compare volumes among neonates treated for culture-negative-sepsis, sepsis-rule-outs, and bloodstream infections (BSI).
Observational cohort of blood cultures collected during NICU stay. Association of age, weight, gender, source, and collection time with lower-than-recommended volumes was determined by logistic regression. Blood culture inocula of patients with culture-negative-sepsis, sepsis rule-out, and BSI were compared using ANOVA.
742 blood cultures were obtained from 292 neonates. Median inoculum was 1 mL (IQR:0.6-1.4), and 259 bottles (35%) had inocula <0.9 mL. Night shift sample collection was associated with lower-than-recommended volumes (p = 0.006). No difference in sample volumes was observed between culture-negative-sepsis, sepsis-rule-outs, and BSI (p = 0.5).
Median NICU blood culture volumes align with recommendations. Night shift collections correlate with lower volumes. Sample volumes don't differ in patients with culture-negative-sepsis, BSI, and sepsis-rule-out, and should not be a justification for longer duration of antibiotics.
评估血培养样本量，确定与样本量不足相关的因素，并比较培养阴性脓毒症、脓毒症排除和血流感染（BSI）患者的样本量。
对新生儿重症监护病房（NICU）住院期间采集的血培养进行观察性队列研究。通过逻辑回归确定年龄、体重、性别、来源和采集时间与低于推荐量的关系。使用方差分析比较培养阴性脓毒症、脓毒症排除和 BSI 患者的血培养接种物。
从 292 名新生儿中获得了 742 份血培养物。接种物中位数为 1 mL（IQR：0.6-1.4），259 瓶（35%）的接种物<0.9 mL。夜间采集样本与低于推荐量相关（p = 0.006）。培养阴性脓毒症、脓毒症排除和 BSI 患者的样本量无差异（p = 0.5）。
NICU 血培养的中位数样本量符合建议。夜间采集与较低的样本量相关。培养阴性脓毒症、BSI 和脓毒症排除患者的样本量无差异，不应成为延长抗生素使用时间的理由。
