Source
Oman Medical Journal, v. 39, no. 1, e588 p. [1-10].
English abstract
In the blood culture procedure for neonatal sepsis, time to positivity (TTP)
reflects the pathogenic bacterial load and the time required for empirical antibiotic
regimen administration prior to definitive treatment. This study aims to identify the
differences in TTP among causative pathogens and its predictive value for the overall
survival of neonates with sepsis at a tertiary healthcare center in Indonesia. Methods:
A retrospective cohort study was conducted from January 2020 to August 2022 at Dr.
Soetomo General Hospital, Surabaya, Indonesia. Neonates with blood culture-proven
neonatal sepsis were included in the analysis. TTP was defined as the time between
the acceptance of a blood culture specimen from the neonatal intensive care unit and
reports of positive culture growth by the laboratory. Results: Across 125 cases, the
median TTP was 58.1 hours (IQR = 24.48). Blood cultures were positive within 48
hours for 41.6% of cases, 72 hours for 86.4%, and 96 hours for 98.4%. A significantly
shorter TTP was exhibited by the three major gram-negative organisms (Klebsiella
pneumoniae, Acinetobacter baumannii, Enterobacter cloacae) compared to coagulasenegative Staphylococci. The neonatal sepsis mortality rate was 49.6% during the study
period. In the Cox multivariate regression model, a shorter TTP was an independently
predicted mortality in the entire cohort (hazard ratio (HR) = 0.985, 95% CI: 0.973–
0.998) and the gram-negative sepsis cohort group (HR = 0.983, 95% CI: 0.968–0.999).
Conclusions: TTP predicts different causative pathogens and the overall survival of
neonatal sepsis cases at a tertiary healthcare facility in Indonesia
