Diagnostic Yield of Repeat Blood Cultures and Risk Factors for Bloodstream Infection in Persistent Febrile Neutropenia

BACKGROUND: The optimal frequency of repeat blood cultures in persistent febrile neutropenia (FN) remains unknown. This study aims to identify opportunities for blood culture diagnostic stewardship in persistent FN. METHODS: This is a retrospective cohort study of patients with hematology/oncology diagnoses and an FN episode >3 days. Generalized estimating equation logistic regression models were used to evaluate risk factors for new bloodstream infection (BSI) after FN day 3. RESULTS: Among 620 patients, median FN duration was 5 days and median blood culture bottles collected per patient was 12. On FN day 1, 25% of patients had a positive blood culture; on FN days 2-9,