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Sepsis Diagnosis and Treatment · Journal article
BMC Infectious Diseases · August 27, 2026
Reinforces what was already believed, rather than introducing something new.
This retrospective cohort of 166 ICU patients with bacteremia examined whether rapid time-to-positivity (TTP) in blood cultures predicts in-hospital mortality. Although patients with rapid TTP (< 360 min) had a numerically higher mortality rate (47% vs 39%), the difference did not reach statistical significance (p=0.292), and rapid TTP did not accelerate time to antimicrobial therapy. The finding supports rapid TTP as a surrogate marker of bacterial load and illness severity rather than a cause of worse outcomes.
Retrospective cohort study. Adult patients admitted to the intensive care unit with positive blood cultures at AdventHealth Central Florida Division hospitals between July 1, 2023, and June 30, 2025.. Intervention: Rapid time to initial positive blood culture (< 360 min). Compared with: Prolonged time to initial positive blood culture (> 360 min). n = 166. AdventHealth Central Florida Division hospitals (single institution/division).
In-hospital mortality was 47% in the rapid TTP group (< 360 min, n=81) versus 39% in the prolonged TTP group (>360 min, n=85), p=0.292 (not statistically significant) MRSA bacteremia and higher APACHE II scores were independently associated with increased mortality in multivariable analysis Infectious disease consultation was independently associated with reduced mortality
Non-statistically significant primary outcome (p=0.292) limits confidence in the mortality difference No report of absolute risk reduction, confidence intervals around mortality estimates, or hazard ratios
The lack of statistical significance and absence of acceleration in antimicrobial therapy initiation suggest that rapid TTP should be interpreted as a marker of disease severity rather than a driver of delayed treatment. Clinicians should not rely on TTP alone to predict mortality risk or guide therapy timing, but should recognize it as reflecting underlying bacterial burden.
Retrospective cohort study of 166 ICU patients confirming that rapid time-to-positivity in blood cultures may serve as a marker of illness severity and bacterial burden, though the mortality difference (47% vs 39%, p=0.292) was not statistically significant.
As stated by the source record.
Quoted from the source exactly as published.
The lack of statistical significance and absence of acceleration in antimicrobial therapy initiation suggest that rapid TTP should be interpreted as a marker of disease severity rather than a driver of delayed treatment. Clinicians should not rely on TTP alone to predict mortality risk or guide therapy timing, but should recognize it as reflecting underlying bacterial burden.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background Bacteremia in critically ill patients is associated with a high risk of morbidity and mortality. Delays between blood culture collection, result availability, and adjustment to proper antimicrobial therapy can lead to worse clinical outcomes. This study evaluated whether shorter time-to-positivity was associated with increased in-hospital mortality among critically ill patients with bacteremia. Methods This retrospective analysis was performed on adult patients admitted to the intensive care unit (ICU) with positive blood cultures at AdventHealth Central Florida Division hospitals from July 1, 2023, through June 30, 2025. The primary outcome was in-hospital mortality. Secondary outcomes include time to empiric antimicrobial therapy, time to positive blood culture, appropriate empiric antibiotic coverage, length of definitive treatment, and hospital length of stay. Results A total of 166 patients were included in the final analysis. Patients were divided into two separate groups, rapid time to initial positive blood culture (< 360 min, n = 81) and prolonged time to initial positive blood culture (> 360 min, n = 85). Patients with rapid TTP suffered higher all-cause in-hospital mortality (47%) compared to the prolonged TTP group (39%; p = 0.292), although not statistically significant. In the multivariable analysis, MRSA bacteremia and higher APACHE II scores were independently associated with increased mortality, while infectious disease consultation was associated with reduced mortality. Conclusion These findings support existing evidence that shorter TTP may serve as an early surrogate marker of bacterial burden and illness severity in critically ill patients with bacteremia. Although rapid TTP did not shorten time to empiric or definitive antimicrobial therapy, it may be associated with higher in-hospital mortality, suggesting that rapid microbial growth may reflect higher burden of infection.
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