{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:32:58Z","timestamp":1794313978893,"version":"4.9.0"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Antibiotic therapy is typically initiated and continued for 36 or 48 hours in neonatal patients while awaiting blood culture results. Our study aims to determine time to positivity (TTP) of positive blood cultures in a level IV neonatal intensive care unit (NICU) to determine the appropriate duration of empiric antibiotics.<\/jats:p>\n <\/jats:sec>\n \n PATIENTS AND METHODS<\/jats:title>\n This is a retrospective study of all patients admitted to the NICU with a positive blood culture from January 2021 to March 2025. Only the first positive blood culture per patient was included in the analysis unless a new organism was identified in subsequent cultures or if 14 days had passed since the previous positive blood culture. Polymicrobial cultures were excluded from analysis unless a subsequent culture demonstrated continued positivity with a single organism.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 63 positive blood cultures from 59 patients were included in the analysis. The median TTP for gram-negative and gram-positive definite pathogens was 9 hours (IQR 7.79, 10.52) and 16.2 hours (IQR 13.76, 18.57), respectively. At 24 hours, 97% (30\/31) of definite pathogens were reported as positive, and at 36 hours, 100% (52\/52) of definite and possible pathogens were reported as positive.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n All blood cultures with definite and possible pathogens were reported as positive by 36 hours. A 36-hour course of empiric antibiotics should be considered in neonates without signs of site-specific infection and without other pending cultures. Shortening courses to 24 hours may also be reasonable, particularly for gram-negative pathogens.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2026-009368","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:02:40Z","timestamp":1784764960000},"page":"e761-e767","source":"Crossref","is-referenced-by-count":1,"title":["Time to Blood Culture Positivity Supports Shorter Rule Outs in a Level IV NICU"],"prefix":"10.1542","volume":"16","author":[{"given":"Amanda L.","family":"Hurst","sequence":"first","affiliation":[{"name":"1Department of Pharmacy, Sanford USD Medical Center, Sioux Falls, South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijo","family":"Roiko","sequence":"additional","affiliation":[{"name":"2Sanford Laboratories, Sanford USD Medical Center, Sioux Falls, South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Tisler","sequence":"additional","affiliation":[{"name":"1Department of Pharmacy, Sanford USD Medical Center, Sioux Falls, South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauritz R.","family":"Meyer","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, Sanford USD Medical Center, Sioux Falls, South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Free","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, Sanford USD Medical Center, Sioux Falls, South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"issue":"1","key":"2026093020010835000_r1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.mayocp.2020.07.019","article-title":"Association of infant antibiotic exposure with childhood health outcomes","volume":"96","author":"Aversa","year":"2021","journal-title":"Mayo Clin Proc."},{"issue":"7","key":"2026093020010835000_r2","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1093\/jac\/dkx088","article-title":"Antibiotic exposure in neonates and early adverse outcomes: a systematic review and meta-analysis","volume":"72","author":"Esaiassen","year":"2017","journal-title":"J Antimicrob Chemother."},{"key":"2026093020010835000_r3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jpeds.2016.11.002","article-title":"Antibiotic exposure and risk for death or bronchopulmonary dysplasia in very low birth weight infants","volume":"181","author":"Cantey","year":"2017","journal-title":"J Pediatr."},{"issue":"4","key":"2026093020010835000_r4","doi-asserted-by":"crossref","first-page":"e2023065267","DOI":"10.1542\/peds.2023-065267","article-title":"Update to the neonatal early-onset sepsis calculator utilizing a contemporary cohort","volume":"154","author":"Kuzniewicz","year":"2024","journal-title":"Pediatrics."},{"issue":"6","key":"2026093020010835000_r5","doi-asserted-by":"crossref","first-page":"e20182896","DOI":"10.1542\/peds.2018-2896","article-title":"Committee on Infectious Diseases. Management of neonates born at \u226434 6\/7 weeks\u2019 gestation with suspected or proven early-onset bacterial sepsis","volume":"142","author":"Puopolo","year":"2018","journal-title":"Pediatrics."},{"issue":"6","key":"2026093020010835000_r6","doi-asserted-by":"crossref","first-page":"e20182894","DOI":"10.1542\/peds.2018-2894","article-title":"Committee on Infectious Diseases. Management of neonates born at \u226535 0\/7 weeks\u2019 gestation with suspected or proven early-onset bacterial sepsis","volume":"142","author":"Puopolo","year":"2018","journal-title":"Pediatrics."},{"issue":"9","key":"2026093020010835000_r7","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1542\/hpeds.2021-005873","article-title":"Time to blood culture positivity by pathogen and primary service","volume":"11","author":"MacBrayne","year":"2021","journal-title":"Hosp Pediatr."},{"issue":"9","key":"2026093020010835000_r8","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1001\/jamapediatrics.2014.895","article-title":"Blood culture time to positivity in febrile infants with bacteremia","volume":"168","author":"Biondi","year":"2014","journal-title":"JAMA Pediatr."},{"issue":"12","key":"2026093020010835000_r9","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1038\/s41372-024-02031-0","article-title":"Time to positivity of blood cultures in a level IV NICU varies based on organism category and population subgroups: is a 36-hour rule out safe?","volume":"44","author":"Nishihara","year":"2024","journal-title":"J Perinatol."},{"issue":"3","key":"2026093020010835000_r10","doi-asserted-by":"crossref","first-page":"102","DOI":"10.4103\/jgid.jgid_1_17","article-title":"Time to positivity and antibiotic sensitivity of neonatal blood cultures","volume":"9","author":"Abdelhamid","year":"2017","journal-title":"J Glob Infect Dis."},{"issue":"5","key":"2026093020010835000_r11","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1080\/14767058.2019.1617687","article-title":"Time to positivity (TTP) of neonatal blood cultures: a trend analysis over a decade from Ireland","volume":"34","author":"Huggard","year":"2021","journal-title":"J Matern Fetal Neonatal Med."},{"issue":"2","key":"2026093020010835000_r12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3390\/antibiotics10020123","article-title":"Time to positivity of blood cultures could inform decisions on antibiotics administration in neonatal early-onset sepsis","volume":"10","author":"De Rose","year":"2021","journal-title":"Antibiotics (Basel)."},{"issue":"7","key":"2026093020010835000_r13","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/INF.0000000000002632","article-title":"Time to positivity of neonatal blood cultures for early-onset sepsis","volume":"39","author":"Kuzniewicz","year":"2020","journal-title":"Pediatr Infect Dis J."},{"issue":"5","key":"2026093020010835000_r14","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/archdischild-2021-322844","article-title":"Dual-site blood culture yield and time to positivity in neonatal late-onset sepsis","volume":"107","author":"Coggins","year":"2022","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"issue":"7","key":"2026093020010835000_r15","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1038\/s41372-025-02323-z","article-title":"Time to positive blood cultures in neonatal sepsis evaluations","volume":"45","author":"Willey","year":"2025","journal-title":"J Perinatol."},{"issue":"6","key":"2026093020010835000_r16","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1128\/JCM.02919-15","article-title":"Diagnosis of bloodstream infections in children","volume":"54","author":"Dien Bard","year":"2016","journal-title":"J Clin Microbiol."}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/16\/10\/e761\/1945227\/hosppeds.2026009368.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/16\/10\/e761\/1945227\/hosppeds.2026009368.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:01:12Z","timestamp":1790812872000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/16\/10\/e761\/208273\/Time-to-Blood-Culture-Positivity-Supports-Shorter"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,7,23]]},"published-print":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2026-009368","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"value":"2154-1663","type":"print"},{"value":"2154-1671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}