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Time to positivity of Coagulase Negative Staphylococcus In Neonatal Blood Cultures as an adjunct tool to help discriminate between sepsis and contamination

Journal of Perinatology volume 45, pages 111–115 (2025)Cite this article

Subjects

Abstract

Objective

To assess the usefulness of time to positivity (TTP) to distinguish between sepsis and contamination in coagulase-negative staphylococci (CoNS) isolates.

Study design

Unicentric retrospective observational. Medical records of 168 patients with suspected sepsis and positive blood culture for CoNS were reviewed. Patients were subdivided into sepsis (29%) and probable contamination (71%). Logistic regression analyses were performed to evaluate different risk factors and clinical signs and symptoms associated with sepsis.

Results

TTP cut-off value that best discriminated sepsis from contamination was found to be 18 h. Regression analysis revealed that TTP ≤ 18 h, gestational age ≤32 weeks, taquycardia/bradycardia and hypoactivity/lethargy were independent predictors of sepsis.

Conclusion

TTP is useful in distinguishing sepsis from contamination, especially in neonates with lower gestational age (<32 weeks). The clinical signs that most increase the discriminatory power of TTP are the presence of tachycardia/bradycardia or hypoactivity.

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Data availability

The data that support the findings of this study are available from the corresponding author, SC-S, upon reasonable request.

References

  1. Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017;390:1770–80.

    Article  PubMed  Google Scholar 

  2. Speier RL, Cotten CM, Benjamin DK, Lewis K, Keeler K, Kidimbu G, et al. Late-onset sepsis evaluation and empiric therapy in extremely low gestational age newborns. J Pediatr Infect Dis Soc. 2023;12:S37–43.

    Article  Google Scholar 

  3. Cantey JB, Pyle AK, Wozniak PS, Hynan LS, Sánchez PJ. Early antibiotic exposure and adverse outcomes in preterm, very low birth weight infants. J Pediatr. 2018;203:62–7.

    Article  CAS  PubMed  Google Scholar 

  4. Healy CM, Baker CJ, Palazzi DL, Campbell JR, Edwards MS. Distinguishing true coagulase-negative Staphylococcus infections from contaminants in the neonatal intensive care unit. J Perinatol. 2013;33:52–8.

    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. López Sastre JB, Coto Cotallo D, Fernández Colomer B, Grupo de Hospitales Castrillo. Neonatal sepsis of nosocomial origin: an epidemiological study from the ‘Grupo de Hospitales Castrillo’. J Perinat Med. 2002;30:149–57.

    Article  PubMed  Google Scholar 

  7. Hajjar N, Ting JY, Shah PS, Lee K-S, Dunn MS, Srigley JA, et al. Blood culture collection practices in NICU; A national survey. Paediatr Child Health. 2023;28:166–71.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ryder JH, Van Schooneveld TC, Diekema DJ, Fabre V. Every crisis is an opportunity: advancing blood culture stewardship during a blood culture bottle shortage. Open Forum Infect Dis 2024;11. https://doi.org/10.1093/ofid/ofae479.

  9. Mukhopadhyay S, Briker SM, Flannery DD, Dhudasia MB, Coggins SA, Woodford E, et al. Time to positivity of blood cultures in neonatal late-onset bacteraemia. Arch Dis Child Fetal Neonatal Ed. 2022;107:583–8.

    Article  PubMed  Google Scholar 

  10. Gastmeier P, Geffers C, Schwab F, Fitzner J, Obladen M, Rüden H. Development of a surveillance system for nosocomial infections: the component for neonatal intensive care units in Germany. J Hospital Infect. 2004;57:126–31.

    Article  CAS  Google Scholar 

  11. Piening BC, Geffers C, Gastmeier P, Schwab F. Pathogen-specific mortality in very low birth weight infants with primary bloodstream infection. PLoS One. 2017;12. https://doi.org/10.1371/journal.pone.0180134.

  12. Wójkowska-Mach J, Gulczyńska E, Nowiczewski M, Borszewska-Kornacka M, Domańska J, Merritt TA et al. Late-onset bloodstream infections of Very-Low-Birth-Weight infants: Data from the Polish Neonatology Surveillance Network in 2009-2011. BMC Infect Dis. 2014;14. https://doi.org/10.1186/1471-2334-14-339.

  13. Singh J, Jain S, Chawla D, Randev S, Khurana S. Peripheral perfusion index as a marker of sepsis in preterm neonates. J Trop Pediatr. 2022;68. https://doi.org/10.1093/tropej/fmac014.

  14. Cantey JB, Baird SD. Ending the culture of culture-negative sepsis in the neonatal ICU. Pediatrics. 2017;140. https://doi.org/10.1542/peds.2017-0044.

  15. Fernandez Colomer B, Cernada Badia M, Coto Cotallo D, Lopez Sastre J. The Spanish National Network Grupo Castrillo: 22 Years of Nationwide Neonatal Infection Surveillance. Am J Perinatol. 2020;37:S71–75.

    Article  PubMed  Google Scholar 

  16. Kuzniewicz MW, Mukhopadhyay S, Li S, Walsh EM, Puopolo KM. Time to positivity of neonatal blood cultures for early-onset sepsis. Pediatr Infect Dis J. 2020;39:634–40.

    Article  PubMed  Google Scholar 

  17. Arias-Felipe A, Ramírez-Berrios J, Recio-Martinez R, Orellana-Miguel MA, Fontiveros-Escalona D, Bergón-Sendín E, et al. Determining time to positivity of blood cultures in a neonatal unit. J Pediatr Infect Dis Soc. 2022;11:510–3.

    Article  Google Scholar 

  18. Craft A, Finer N. Nosocomial coagulase negative staphylococcal (CoNS) catheter-related sepsis in preterm infants: definition, diagnosis, prophylaxis, and prevention. J Perinatol. 2001;21:186–92.

    Article  CAS  PubMed  Google Scholar 

  19. Flannery DD, Edwards EM, Coggins SA, Horbar JD, Puopolo KM. Late-onset sepsis among very preterm infants. Pediatrics. 2022;150. https://doi.org/10.1542/PEDS.2022-058813.

  20. 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 

  21. Freeman J, Goldmann DA, Smith NE, Sidebottom DG, Epstein MF, Platt R. Association of intravenous lipid emulsion and coagulase-negative staphylococcal bacteremia in neonatal intensive care units. N. Engl J Med. 1990;323:301–8.

    Article  CAS  PubMed  Google Scholar 

  22. Schelonka RL, Chai MK, Yoder BA, Hensley D, Brockett RM, Ascher DP. Volume of blood required to detect common neonatal pathogens. J Pediatr. 1996;129:275–8.

    Article  CAS  PubMed  Google Scholar 

  23. Connell TG, Rele M, Cowley D, Buttery JP, Curtis N. How reliable is a negative blood culture result? Volume of blood submitted for culture in routine practice in a children’s hospital. Pediatrics. 2007;119:891–6.

    Article  PubMed  Google Scholar 

  24. Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the infectious diseases society of america and the american society for microbiology. Clin Infect Dis. 2018;67:e1–94.

    Article  PubMed  Google Scholar 

  25. Garcia-Prats JA, Cooper TR, Schneider VF, Stager CE, Hansen TN. Rapid detection of microorganisms in blood cultures of newborn infants utilizing an automated blood culture system. Pediatrics. 2000;105:523–7.

    Article  CAS  PubMed  Google Scholar 

  26. Jardine L, Davies MW, Faoagali J. Incubation time required for neonatal blood cultures to become positive. J Paediatr Child Health. 2006;42:797–802.

    Article  PubMed  Google Scholar 

  27. Huggard D, Powell J, Kirkham C, Power L, O’Connell NH, Philip RK. Time to positivity (TTP) of neonatal blood cultures: a trend analysis over a decade from Ireland. J Matern-Fetal Neonatal Med. 2021;34:780–6.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Pediatrics Unit, Clinic University Hospital, Valencia, Spain

    Silvia Carbonell-Sahuquillo & Raquel Pérez-Suárez

  2. Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain

    Beatriz Olea, Estela Giménez, Javier Colomina & David Navarro

  3. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain

    David Navarro

  4. Neonatal Unit, Clinic University Hospital, Valencia, Spain

    Javier Estañ-Capell

  5. Department of Pediatrics, School of Medicine, University of Valencia, Valencia, Spain

    Javier Estañ-Capell

Authors
  1. Silvia Carbonell-Sahuquillo
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  2. Beatriz Olea
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  4. Estela Giménez
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  5. Javier Colomina
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  7. Javier Estañ-Capell
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Contributions

Study design (SC-S, BO, JE-C, JC, DN), data collection (SC-S, RP-S, JC), analyses (BO, EG), first manuscript draft (SC-S, BO, JE-C). All authors revised the manuscript critically for substantive content and approved the final version.

Corresponding author

Correspondence to Silvia Carbonell-Sahuquillo.

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Carbonell-Sahuquillo, S., Olea, B., Pérez-Suárez, R. et al. Time to positivity of Coagulase Negative Staphylococcus In Neonatal Blood Cultures as an adjunct tool to help discriminate between sepsis and contamination. J Perinatol 45, 111–115 (2025). https://doi.org/10.1038/s41372-024-02158-0

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