A comparison of two versus one blood culture in the diagnosis and treatment of coagulase-negative staphylococcus in the neonatal intensive care unit.
OBJECTIVE
This study compares two versus one blood culture in the diagnosis and treatment of coagulase-negative staphylococcus (CONS) in babies with suspected sepsis.


METHODS
The study was performed at British Columbia's Children's Hospital Neonatal Intensive Care Unit between March 1999 to March 2000. One hundred pairs of cultures were drawn from two percutaneous sites from babies more than 48 hours old at the time of a sepsis screen. CONS cultured from both sites was regarded as evidence of infection. Positive culture from only one of the two sites was regarded as contaminant. The difference in rates of diagnosed CONS infection and reduction in antibiotic usage when using two versus one blood culture was calculated.


RESULTS
In 5% of babies, cultures from a second site did not substantiate the diagnosis of CONS when compared to the result from a single culture. The resultant reduction in antibiotic use was 8.2%.


CONCLUSIONS
Two blood cultures reduce the number of children diagnosed with CONS infection and reduce antibiotic usage.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001800:Blood Specimen Collection; D003030:Coagulase / Q000378:metabolism; D003428:Cross Infection / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D017410:Practice Guidelines as Topic; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D003030:Coagulase; D014640:Vancomycin