ArticlePloS one2019
Time to positivity of blood cultures supports early re-evaluation of empiric broad-spectrum antimicrobial therapy.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers.
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Who cites it
53 citing papers in PubMed, 91 citations in OpenAlex.
- Risk Factors of Blood Culture Positivity and Mortality in Bloodstream Infections: A Population-Based Study of Patients With B-Cell Malignancies.European journal of haematology · 2026Article
- Re-incubation of positive anaerobic blood culture bottles for detecting additional anaerobes in polymicrobial bacteremia.Microbiology spectrum · 2026Observational
- Diagnostic performance of procalcitonin for predicting bloodstream infection and guidance on microbial aetiology: a prospective study at an Egyptian tertiary care hospital.BMC infectious diseases · 2026Article
- Rapid Molecular Diagnostics for Bloodstream Infection in Patients with Chronic Kidney Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Bacterial species differentiation via real-time detection of microbial volatile organic compounds using a wavelength multiplexed photoionization detector and AI image-based analysis.Scientific reports · 2026Article
- Likelihood of Blood Culture Positivity Using SeptiCyte RAPID.Journal of clinical medicine · 2026Article
- The Clinical Utility and Stewardship Challenges of Time to Blood Culture Positivity.Hospital pharmacy · 2026Article
- Comparative Evaluation of Sequencing Technologies for Detecting Antimicrobial Resistance in Bloodstream Infections.Antibiotics (Basel, Switzerland) · 2025Review
- Plug-and-Play Centrifuge-Only Device for Rapid Sepsis Diagnosis.Advanced healthcare materials · 2025Article
- Rapid colorimetric antimicrobial susceptibilities direct from positive blood culture for Gram-negative bacteria.Microbiology spectrum · 2025Article
- Culture-free detection of bacteria from blood for rapid sepsis diagnosis.NPJ digital medicine · 2025Article
- Clinical Utility of Plasma Microbial Cell-Free DNA Surveillance in Neutropenic Patients with Acute Myeloid Leukemia Undergoing Outpatient Chemotherapy: A Case Series.Diagnostics (Basel, Switzerland) · 2025Article
- Likelihood of blood culture positivity using SeptiCyte RAPID.medRxiv : the preprint server for health sciences · 2025Article
- Antimicrobial stewardship principles in the evaluation of empirical carbapenem antibiotics in a private hospital in South Africa.JAC-antimicrobial resistance · 2025Article
- Diagnostic and prognostic value of time to positivity in blood cultures. An opinion paper.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Combination of nucleated red blood cells and inflammatory biomarkers (PCT and CRP) for predicting sepsis and septic shock in children.Frontiers in cellular and infection microbiology · 2025Article
- Article
- A mathematical model to estimate the probability of blood cultures positive for pyogenic streptococci.Le infezioni in medicina · 2025Article
- Impact of inappropriate empirical antibiotic therapy on in-hospital mortality: a retrospective multicentre cohort study of patients with bloodstream infections in Chile, 2018-2022.BMJ public health · 2024Article
- Time-to-Positivity for Candida in Bloodstream Infections: Prognostic Implications for Mortality.Cureus · 2024Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBlood cultures are considered the gold standard to distinguish bacteremia from non-bacteremic systemic inflammation. In current clinical practice, bacteraemia is considered unlikely if blood cultures have been negative for 48-72 hours. Modern BC systems have reduced this time-to-positivity (TTP), questioning whether the time frame of 48-72 hrs is still valid. This study investigates the distribution of TTP, the probability of blood culture positivity after 24 hours, and identifies clinical predictors of prolonged TTP.
methodsAdult patients with monomicrobial bacteremia in an academic hospital were included retrospectively over a three-year period. Clinical data were retrieved from the medical records. Predictors of TTP >24 hours were determined by uni- and multivariate analyses. The residual probability of bacteremia was estimated for the scenario of negative BCs at 24 hours after bedside collection.
resultsThe cohort consisted of 801 patients, accounting for 897 episodes of bacteremia. Mean age was 65 years (IQR 54-73), 534 (59.5%) patients were male. Median TTP was 15.7 (IQR 13.5-19.3) hours. TTP was ≤24 hours in 85.3% of episodes. Antibiotic pre-treatment (adjusted OR 1.77; 95%CI 1.14-2.74, p<0.01) was independently associated with prolonged TTP. The probability of bacteremia, if BC had remained negative for 24 hours, was 1.8% (95% CI 1.46-2.14).
conclusionWith adequate hospital logistics, the probability of positive blood cultures after 24 hours of negative cultures was low. Combined with clinical reassessment, knowledge of this low probability may contribute to prioritization of the differential diagnosis and decisions on antimicrobial therapy. As a potential antibiotic stewardship tool, this strategy warrants further prospective investigation.
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