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Background   Pseudomonas aeruginosa  ( P. aeruginosa ) is a major Gram-negative pathogen, which has been reported to result in high mortality. We aim to investigate the prognostic value and optimum cut-off point of time-to-positivity (TTP) of blood culture in children with  P. aeruginosa  bacteremia.    Methods  From August 2014 to November 2018, we enrolled the inpatients with  P. aeruginosa  bacteremia in a 1500-bed tertiary teaching hospital in Chongqing, China retrospectively. Receiver operating characteristic (ROC) analysis was used to determine the optimum cut-off point of TTP, and logistic regression were employed to explore the risk factors for in-hospital mortality and septic shock.    Results  Totally, 52 children with  P. aeruginosa  bacteremia were enrolled. The standard cut-off point of TTP was18 h. Early TTP (≤18 h) group patients had remarkably higher in-hospital mortality (42.9% vs 9.7%,  P  = 0.014), higher incidence of septic shock (52.4%  vs 12.9%,  P  = 0.06), higher Pitt bacteremia scores [3.00 (1.00–5.00) vs 1.00 (1.00–4.00),  P  = 0.046] and more intensive care unit admission (61.9% vs 22.6%,  P  = 0.008) when compared with late TTP (> 18 h) groups. Multivariate analysis indicated TTP ≤18 h, Pitt bacteremia scores ≥4 were the independent risk factors for in-hospital mortality (OR 5.88, 95%CI 1.21–21.96,  P  = 0.035; OR 4.95, 95%CI 1.26–27.50,  P  = 0.024; respectively). The independent risk factors for septic shock were as follows: TTP ≤18 h, Pitt bacteremia scores ≥4 and hypoalbuminemia (OR 6.30, 95%CI 1.18–33.77,  P  = 0.032; OR 8.15, 95%CI 1.15–42.43,  P  = 0.014; OR 6.46, 95% CI 1.19–33.19  P  = 0.031; respectively).    Conclusions  Early TTP (≤18 hours) appeared to be associated with worse outcomes for  P. aeruginosa  bacteremia children.

Prognostic role of time to positivity of blood culture in children with Pseudomonas aeruginosa bacteremia