# Factors associated with persistent blood stream infection in the Neonatal Intensive Care Unit

## TL;DR

This study identifies factors that increase the likelihood of persistent blood stream infections in NICU infants, helping determine when follow-up blood cultures are needed.

## Contribution

The study provides new insights into clinical and microbial factors associated with persistent blood stream infections in neonatal intensive care units.

## Key findings

- Staphylococcus aureus, male sex, central venous catheter, and late-onset sepsis are linked to persistent BSI.
- No infants with early-onset sepsis or Streptococcal sp. had persistent BSI.
- Findings can guide diagnostic decisions for follow-up blood cultures in NICUs.

## Abstract

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

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 hours after the index culture.

The recovery of Staphylococcus aureus (OR=6.10, p<.001), male sex (OR=3.31, p=.020), the presence of a central venous catheter (OR=3.73, p=.020), and BSI in the setting of late-onset sepsis (p<.001) were associated with persistent BSI. No infants with either early-onset sepsis or growth of Streptococcal sp. had a persistent BSI.

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