@article {Coggins475, author = {Sarah A Coggins and Mary Catherine Harris and Lakshmi Srinivasan}, title = {Dual-site blood culture yield and time to positivity in neonatal late-onset sepsis}, volume = {107}, number = {5}, pages = {475--480}, year = {2022}, doi = {10.1136/archdischild-2021-322844}, publisher = {BMJ Publishing Group}, abstract = {Objective To determine whether culture yield and time to positivity (TTP) differ between peripheral and central vascular catheter-derived blood cultures (BCx) in neonatal intensive care unit (NICU) patients evaluated for late-onset sepsis.Design Single-centre, retrospective, observational study.Setting Level IV NICU.Participants The study included infants \>72 hours old admitted to NICU in 2007{\textendash}2019 with culture-confirmed bacteraemia. All episodes had simultaneous BCx drawn from a peripheral site and a vascular catheter ({\textquoteleft}catheter culture{\textquoteright}).Main outcome measures Dual-site culture yield and TTP.Results Among 179 episodes of late-onset bacteraemia (among 167 infants) with concurrently drawn peripheral and catheter BCx, the majority (67\%, 120 of 179) were positive from both sites, compared with 17\% (30 of 179) with positive catheter cultures only and 16\% (29 of 179) with positive peripheral cultures only. 66\% (19 of 29) of episodes with only positive peripheral BCx grew coagulase-negative Staphylococcus, while 34\% (10 of 29) were recognised bacterial pathogens. Among 120 episodes with both peripheral and catheter BCx growth, catheter cultures demonstrated bacterial growth prior to paired peripheral cultures in 78\% of episodes (93 of 120, p\<0.001). The median TTP was significantly shorter in catheter compared with peripheral cultures (15.0 hours vs 16.8 hours, p\<0.001). The median elapsed time between paired catheter and peripheral culture growth was 1.3 hours.Conclusion Concurrently drawn peripheral and catheter BCx had similar yield. While a majority of episodes demonstrated dual-site BCx growth, a small but important minority of episodes grew virulent pathogens from either culture site alone. While dual-site culture practices may be useful, clinicians should balance the gain in sensitivity of bacteraemia detection against additive contamination risk.No data are available. Not applicable.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/107/5/475}, eprint = {https://fn.bmj.com/content/107/5/475.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }