28 Blood culture collection practices in NICU; A national survey
Bibliographic record
Abstract
Abstract Background Blood cultures are the gold standard in the investigation of neonatal sepsis, which is associated with significant morbidity and mortality. However, there are currently no consensus guidelines for blood collection for culture in newborns. In addition, it can be challenging to obtain sufficient blood volume in infants, which can affect the validity of culture results. Objectives To examine current practices in blood collection for culture in the investigation of neonatal sepsis in NICUs across Canada. Design/Methods A 9-item electronic survey (Appendix A) was sent to each of the 29 level 3 NICUs in Canada, which are equipped to provide highly specialized care for newborns. Results Responses were received from 26 (90%) of the 29 level 3 NICUs. Fifty-six percent of NICUs have blood collection guidelines for the investigation of neonatal sepsis. Forty-eight percent of NICUs routinely collect 1.0 mL of blood per culture bottle. By contrast, 32% of NICUs determine adequate blood volume using body weight and 8% using gestational age. In late-onset neonatal sepsis (LONS), 58% of centres process one aerobic culture bottle. Four NICUs (15%) routinely add anaerobic culture bottles. Few centres draw blood for culture from an indwelling catheter when present as a first-line option in LONS. Specifically, one NICU routinely draws blood from a central venous line and four NICUs (17%) routinely draw from a peripheral arterial line. In early-onset neonatal sepsis (EONS), 73% of NICUs draw blood for culture from umbilical lines, while 72% use peripheral venepuncture. Two centres routinely collect cord blood from the placenta for culture in EONS. Only one NICU applies the concept of differential time-to-positivity (DTP) in suspected central-line associated bloodstream infection (CLABSI) to determine whether a colonized catheter is the true source of infection. Conclusion There is significant practice variation in blood collection for culture in level 3 NICUs across Canada. Standardization of blood collection practices will improve antimicrobial stewardship and appropriate resource utilization, as well as provide reliable estimates of the true incidence of neonatal sepsis in Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".