{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:15:36Z","timestamp":1781604936641,"version":"3.54.5"},"reference-count":15,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1128\/ASMCopyrightv2"},{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2024,11,13]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Repeat blood cultures are common in children after an initial positive culture. However, in contrast to adults, there are little data to help guide clinicians when a repeat culture is necessary to assess for persistent bacteremia. This study identifies factors associated with persistent bloodstream infections (BSI) in children to inform diagnostic stewardship. This cross-sectional study of children less than 18 years with at least one positive blood culture over a 5-year period utilized a generalized linear equation model to predict patient and microbial factors associated with persistent BSI defined as a positive blood culture with the same organism &gt;48 hours after the index culture. Four hundred and five patients had 502 positive blood cultures yielding 556 organisms. Sixty-seven (13.2%) cultures were persistently positive. Anaerobic organisms (0\/37) and\n              <jats:italic>Streptococcus<\/jats:italic>\n              species (0\/104) were never recovered from repeat cultures.\n              <jats:italic>Staphylococcus aureus<\/jats:italic>\n              (OR 9.45, CI 5.15\u201317.35) and yeast (OR 78.18, CI 9.45\u2013646.6) were statistically associated with persistent BSI. Patients with prior positive cultures (OR 1.44, CI 1.12\u20131.84) or a central venous catheter (OR 2.20, 95% CI 1.04\u20133.92) were also at risk for persistence. Immune dysfunction and elevated inflammatory markers at the time of the index blood culture were not significantly associated with persistence. Yeast or\n              <jats:italic>S. aureus<\/jats:italic>\n              were associated with persistent BSI, while anaerobes and\n              <jats:italic>Streptococcus<\/jats:italic>\n              species were never persistent. Patient characteristics at the time of blood draw did not predict persistence other than having previous positive blood cultures or a central venous catheter. These data can inform when repeat blood cultures have clinical value and reduce the risk of unnecessary blood draws in children.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>We identify factors associated with bloodstream infection persistence in children. Our findings can help guide blood culture stewardship efforts in pediatric patients, especially in light of blood culture supply shortages.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/jcm.00998-24","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T13:00:41Z","timestamp":1728046841000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Persistent bloodstream infection in children: examining the role for repeat blood cultures"],"prefix":"10.1128","volume":"62","author":[{"given":"Christine M.","family":"Puthawala","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Feinn","sequence":"additional","affiliation":[{"name":"Frank H. Netter School of Medicine, Department of Medical Sciences, Quinnipiac University, Hamden, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Rivera-Vi\u00f1as","sequence":"additional","affiliation":[{"name":"Infection Prevention Department, Yale New Haven Health, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section Infectious Diseases &amp; Global Health, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6829-7213","authenticated-orcid":false,"given":"Thomas S.","family":"Murray","sequence":"additional","affiliation":[{"name":"Infection Prevention Department, Yale New Haven Health, New Haven, Connecticut, USA"},{"name":"Department of Pediatrics, Section Infectious Diseases &amp; Global Health, Yale University School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-5012","authenticated-orcid":false,"given":"David R.","family":"Peaper","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1622-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.86a.18001"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix648"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1821"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25466"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piaa029"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq146"},{"key":"e_1_3_3_10_2","volume-title":"Principles and procedures for blood cultures","author":"Wilson ML","year":"2022","unstructured":"Wilson ML. 2022. Principles and procedures for blood cultures. https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m47\/."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2019.04.014"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2021-006012"},{"key":"e_1_3_3_13_2","unstructured":"Disruptions in availability of BD BACTEC blood culture media bottles - letter to health care providers. 2024. Available from: https:\/\/www.fda.gov\/medical-devices\/letters-health-care-providers\/disruptions-availability-bd-bactec-blood-culture-media-bottles-letter-health-care-providers"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae104"},{"key":"e_1_3_3_15_2","volume-title":"CLSI M100 Performance standards for antimicrobial susceptibility testing","author":"Lewis JS","year":"2024","unstructured":"Lewis JS. 2024. CLSI M100 Performance standards for antimicrobial susceptibility testing. 34th ed. https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/.","edition":"34"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2608.191493"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00998-24","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00998-24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T14:02:24Z","timestamp":1731506544000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.00998-24"}},"subtitle":[],"editor":[{"given":"Daniel J.","family":"Diekema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,13]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11,13]]}},"alternative-id":["10.1128\/jcm.00998-24"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00998-24","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,13]]},"assertion":[{"value":"2024-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00998-24"}}