Factors associated with persistent bloodstream infection in the Neonatal Intensive Care Unit.

OBJECTIVE

This study determined factors associated with persistent bloodstream infections (BSIs) for infants in the NICU to identify when follow up blood cultures (FUBCs) have increased utility.

STUDY

DESIGN

Single center study of all infants in a level IV NICU (n = 121) with a positive blood culture over a five-year period. Clinical and microbiological variables were examined with bivariate and multi-regression analyses to identify factors associated with persistent BSI, defined as growth of the same organism >48 h after the index culture.

RESULTS

The recovery of Staphylococcus aureus (OR = 6.10, p < 0.001), male sex (OR = 3.31, p = 0.020), the presence of a central venous catheter (OR = 3.73, p = 0.020), and BSI in the setting of late-onset sepsis (p < 0.001) were associated with persistent BSI. No infants with either early-onset sepsis or growth of Streptococcal sp. had a persistent BSI.

CONCLUSION

In the NICU, both patient and microbial characteristics can inform diagnostic stewardship regarding the need for FUBCs.