Ideal blood inoculant volume for neonatal sepsis evaluation: an alternative approach.

Published on Aug 27, 2021in Pediatric Research2.747
· DOI :10.1038/S41390-021-01720-2
Sripriya Sundararajan3
Estimated H-index: 3
(UMB: University of Maryland, Baltimore)
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Abstract
References23
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#1Emily C. Woodford (Children's Hospital of Philadelphia)H-Index: 3
#2Miren B. Dhudasia (Children's Hospital of Philadelphia)H-Index: 5
Last. Sagori Mukhopadhyay (UPenn: University of Pennsylvania)H-Index: 15
view all 7 authors...
Background Clinicians often express concerns about poor sensitivity of blood cultures in neonates resulting from inadequate inoculant volumes. Our objective was to determine the inoculant volume sent for neonatal sepsis evaluations and identify areas of improvement. Methods Single-center prospective observational study of infants undergoing sepsis evaluation. Blood volume was determined by clinician documentation over 21 months, and additionally by weighing culture bottles during 12 months. Adeq...
1 CitationsSource
#1Catherine C. Cibulskis (SLU: Saint Louis University)
#2Akhil Maheshwari (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 33
Last. Amit M. Mathur (SLU: Saint Louis University)H-Index: 28
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Anemia of prematurity (AOP) is a common condition with a well-described chronology, nadir hemoglobin levels, and timeline of recovery. However, the underlying pathophysiology and impact of prolonged exposure of the developing infant to low levels of hemoglobin remains unclear. Phlebotomy losses exacerbate the gradual decline of hemoglobin levels which is insidious in presentation, often without any clinical signs. Progressive anemia in preterm infants is associated with poor weight gain, inabili...
1 CitationsSource
#1Sripriya Sundararajan (UMB: University of Maryland, Baltimore)H-Index: 3
#2Heike Rabe (BSMS: Brighton and Sussex Medical School)H-Index: 22
Anemia, defined as a low blood hemoglobin concentration, is a major global public health problem. Identification of anemia is crucial to public health interventions. It is estimated globally that 273 million children under 5 years of age were anemic in 2011, and about ~50% of those cases were attributable to iron deficiency (Lancet Global Health 1:e16–e25, 2013). Iron-deficiency anemia (IDA) in infants adversely impacts short-term hematological indices and long-term neuro-cognitive functions of ...
3 CitationsSource
Abstract Purpose This study was conducted to estimate the blood culture volume that should be collected from pediatric patients to improve diagnostic abilities. Methods Blood cultures from neonates and children aged up to 18 years were collected and the volume was measured for over a 1-year period. During the intervention period, examiners were instructed to draw 3 mL of blood for culture, if possible. The pre-intervention period was from June 1 to August 31, 2016. The post-intervention period w...
2 CitationsSource
#1Moni Pankhuri Singh (Nepean Hospital)H-Index: 1
#2Kiran Kumar Balegar (USYD: University of Sydney)H-Index: 1
Last. Rajeshwar Reddy AngitiH-Index: 1
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Background Neonatal sepsis is the leading cause of mortality and morbidity in neonatal intensive care units. The volume of blood taken for culture remains one of the most important factors in isolating microorganisms. Objectives To evaluate the impact of the intervention on the blood volume submitted for culture and to identify factors influencing the volume as determined by the phlebotomist. Methods Blood culture volume was determined by weighing the culture bottle before and immediately after ...
2 CitationsSource
#1S. Huber (Innsbruck Medical University)H-Index: 1
#2Benjamin Hetzer (Innsbruck Medical University)H-Index: 4
Last. Dorothea Orth-Höller (Innsbruck Medical University)H-Index: 13
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Abstract Background Bloodstream infections (BSI) are a major cause of morbidity and mortality in pediatric patients. For fast and accurate diagnosis, blood culture (BC) is the gold standard. However, the procedure for blood sampling in pediatric patients, particularly the optimal blood volume, is the subject of controversy stemming from a lack of knowledge on the bacterial load and because of several obstacles such as low intravascular volume with the risk of causing anemia. Objectives The aim o...
15 CitationsSource
#1Karen M. Puopolo (UPenn: University of Pennsylvania)H-Index: 29
#2William E. Benitz (Stanford University)H-Index: 48
Last. NewbornH-Index: 22
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The incidence of neonatal early-onset sepsis (EOS) has declined substantially over the last 2 decades, primarily because of the implementation of evidence-based intrapartum antimicrobial therapy. However, EOS remains a serious and potentially fatal illness. Laboratory tests alone are neither sensitive nor specific enough to guide EOS management decisions. Maternal and infant clinical characteristics can help identify newborn infants who are at risk and guide the administration of empirical antib...
113 CitationsSource
: The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This docum...
175 CitationsSource
Background:The utilization of placental blood for neonatal admission laboratory tests, specifically the complete blood cell (CBC) count and blood culture, has the potential to delay the onset of anemia of prematurity and intraventricular hemorrhage, frequency of blood transfusions and associated com
4 CitationsSource
#1Freya C Harewood (University of Melbourne)H-Index: 1
#2Nigel Curtis (University of Melbourne)H-Index: 60
Last. Tom G Connell (Royal Children's Hospital)H-Index: 4
view all 6 authors...
The volume of blood sampled for culture critically influences the results. This study aimed to determine (1) the volume of blood submitted for culture, (2) the proportion of blood cultures with ade...
7 CitationsSource
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