title: Blood culture time to positivity in febrile infants with bacteremia.
abstract: OBJECTIVE
  Blood cultures are often obtained as part of the evaluation of infants with fever and these infants are typically observed until their cultures are determined to have no growth. However, the time to positivity of blood culture results in this population is not known.
  
  
  OBJECTIVE
  To determine the time to positivity of blood culture results in febrile infants admitted to a general inpatient unit.
  
  
  METHODS
  Multicenter, retrospective, cross-sectional evaluation of blood culture time to positivity. Data were collected by community and academic hospital systems associated with the Pediatric Research in Inpatient Settings Network. The study included febrile infants 90 days of age or younger with bacteremia and without surgical histories outside of an intensive care unit.
  
  
  METHODS
  Blood culture growing pathogenic bacteria.
  
  
  METHODS
  Time to positivity and proportion of positive blood culture results that become positive more than 24 hours after placement in the analyzer.
  
  
  RESULTS
  A total of 392 pathogenic blood cultures were included from 17 hospital systems across the United States. The mean (SD) time to positivity was 15.41 (8.30) hours. By 24 hours, 91% (95% CI, 88-93) had turned positive. By 36 and 48 hours, 96% (95% CI, 95-98) and 99% (95% CI, 97-100) had become positive, respectively.
  
  
  CONCLUSIONS
  Most pathogens in febrile, bacteremic infants 90 days of age or younger hospitalized on a general inpatient unit will be identified within 24 hours of collection. These data suggest that inpatient observation of febrile infants for more than 24 hours may be unnecessary in most infants.
authors.affiliation: University of Rochester Medical Center, Rochester, New York.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Biondi
authors.affiliation: University of Illinois College of Medicine, Peoria.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mischler
authors.affiliation: Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Jerardi
authors.affiliation: Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Statile
authors.affiliation: Children's Hospital Colorado, Aurora.
authors.forename: Jason
authors.initials: J
authors.lastname: French
authors.affiliation: The Children's Hospital of The King's Daughters, Norfolk, Virginia.
authors.forename: Rianna
authors.initials: R
authors.lastname: Evans
authors.affiliation: Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Vivian
authors.initials: V
authors.lastname: Lee
authors.affiliation: Children's Medical Center, University of Texas Southwestern, Dallas.
authors.forename: Clifford
authors.initials: C
authors.lastname: Chen
authors.affiliation: University of Illinois College of Medicine, Peoria8College of Pharmacy, University of Illinois at Chicago.
authors.forename: Carl
authors.initials: C
authors.lastname: Asche
authors.affiliation: University of Illinois College of Medicine, Peoria.
authors.forename: Jinma
authors.initials: J
authors.lastname: Ren
authors.affiliation: Cincinnati Children's Hospital Medical Center, Division of Hospital Medicine, Cincinnati, Ohio9Section Editor, JAMA Pediatrics.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Shah
mesh_terms: D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques; D001769:Blood / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005334:Fever / Q000097:blood* / Q000382:microbiology; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States