A recent study (GL Fell et al. J Pediatr 2020; 227: 69-76. Optimizing Duration of Empiric Management of Suspected Central Line-Associated Bloodstream Infections in Pediatric Patients with Intestinal Failure) showed that 98% of blood cultures returned positive within 24 hrs.
This prospective single-institution cohort study with 73 patients had 128 Central Line-Associated Bloodstream Infections (CLBSI) in 35 patients during the study period (2015-2018).
- The probability of a blood culture becoming positive after 24 hours was 2.3%; only 1 blood culture became positive after 30 hours (none beyond 48 hrs).
- The median time from blood sampling to positive culture was 11.1 hours.
- Elevated C-reactive protein and neutrophil predominance in white blood cell count were associated with positive blood cultures
My take: 98% is not good enough. For now, 48-hours is the safest policy.
Related blog posts:
- Antibiotic Selection for Suspected Central Line Infections
- #NASPGHAN19 Intestinal Failure Session Part 1
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