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The diagnostic utility of obtaining two blood cultures for the diagnosis of early onset sepsis in neonates

Journal of Perinatology (2024)Cite this article

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A positive blood culture is the gold standard for diagnosing neonatal sepsis [1, 2]. Several factors may affect blood culture reliability, including blood volume obtained, bacterial colony counts, sterile technique, antibiotic exposure, laboratory techniques and culture media, and number of sites cultured [1,2,3,4]. The practice of obtaining two blood cultures from different sites in neonates is common when evaluating for late-onset sepsis (LOS) as a means of potentially increasing yield and differentiating true infection from contamination or line colonization [5]. While this practice has been widely adapted for LOS, limited data exist on its utility for early-onset sepsis (EOS) [5, 6].

The 2018 American Academy of Pediatrics guidelines for EOS state that “use of two separate culture bottles may help determine if commensal species are true infections by comparing growth in two cultures [2].” At the Yale New Haven Children’s Hospital Neonatal Intensive Care Unit (NICU), the practice of obtaining two separate site blood cultures when evaluating for suspected EOS was adopted for this purpose as well as to increase the likelihood of organism recovery. This study examines the utility of a two-blood culture approach in the evaluation for EOS over a 9-year period.

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Data availability

The data that support the findings of this study are not openly available. Deidentified data are available from the corresponding author upon reasonable request.

References

  1. Woodford EC, Dhudasia MB, Puopolo KM, Skerritt LA, Bhavsar M, DeLuca J, et al. Neonatal blood culture inoculant volume: feasibility and challenges. Pediatr Res. 2021;90:1086–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Puopolo KM, Benitz WE, Zaoutis TE, Committee on Fetus and Newborn, Committee on Infectious Diseases. Management of neonates born at ≥35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics. 2018;142:e20182894.

    Article  PubMed  Google Scholar 

  3. Yaacobi N, Bar-Meir M, Shchors I, Bromiker R. A prospective controlled trial of the optimal volume for neonatal blood cultures. Pediatr Infect Dis J. 2015;34:351–4.

    Article  PubMed  Google Scholar 

  4. Flayhart D, Borek AP, Wakefield T, Dick J, Carroll KC. Comparison of BACTEC PLUS blood culture media to BacT/Alert FA blood culture media for detection of bacterial pathogens in samples containing therapeutic levels of antibiotics. J Clin Microbiol. 2007;45:816–21.

    Article  CAS  PubMed  Google Scholar 

  5. Struthers S, Underhill H, Albersheim S, Greenberg D, Dobson S. A comparison of two versus one blood culture in the diagnosis and treatment of coagulase-negative staphylococcus in the neonatal intensive care unit. J Perinatol. 2002;22:547–9.

    Article  PubMed  Google Scholar 

  6. Sarkar S, Bhagat I, DeCristofaro JD, Wiswell TE, Spitzer AR. A study of the role of multiple site blood cultures in the evaluation of neonatal sepsis. J Perinatol. 2006;26:18–22.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Yale School of Medicine, New Haven, CT, USA

    Noa Fleiss, Veronika Shabanova, Thomas S. Murray & Matthew J. Bizzarro

  2. Yale New Haven Children’s Hospital, New Haven, CT, USA

    Thomas S. Murray & Matthew J. Bizzarro

  3. Nationwide Children’s Hospital, Columbus, OH, USA

    Patrick G. Gallagher

  4. Ohio State University, Columbus, OH, USA

    Patrick G. Gallagher

Authors
  1. Noa Fleiss
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  2. Veronika Shabanova
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  3. Thomas S. Murray
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  4. Patrick G. Gallagher
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  5. Matthew J. Bizzarro
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Contributions

Dr. Fleiss participated in the data collection and statistical analysis, drafted the initial manuscript, and reviewed and revised the final manuscript. Dr. Shabanova led the data analysis, created the table in the manuscript, and reviewed and revised the initial and final manuscript. Dr. Murray participated in the study design, contributed to the initial draft of the manuscript, and reviewed and revised the final manuscript. Dr. Gallagher participated in the study design, contributed to the initial draft of the manuscript, and reviewed and revised the final manuscript. Dr. Bizzarro designed the study from the earliest stages, managed the data and participated in the data analysis, drafted the initial manuscript, and reviewed and revised the final manuscript.

Corresponding author

Correspondence to Noa Fleiss.

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Fleiss, N., Shabanova, V., Murray, T.S. et al. The diagnostic utility of obtaining two blood cultures for the diagnosis of early onset sepsis in neonates. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01914-6

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  • DOI: https://doi.org/10.1038/s41372-024-01914-6

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