The Addition of Anaerobic Blood Cultures for Pediatric Patients with Concerns for Bloodstream Infections: Prevalence and Time to Positive Cultures
| Autor: | Rebecca Yee, Jennifer Dien Bard, Keya Manshadi, Hee Jae Choi, Todd P. Chang, Ara Festekjian, Nhan Lichtenfeld |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Pediatric emergency 030106 microbiology Bacteremia Microbiology Cohort Studies 03 medical and health sciences Bacteria Anaerobic 0302 clinical medicine Secondary outcome Sepsis medicine Prevalence Humans Blood culture 030212 general & internal medicine Anaerobiosis Child Time to positivity medicine.diagnostic_test business.industry Obligate anaerobe Bacteriology Anaerobic blood culture Blood Culture business Anaerobic exercise |
| Zdroj: | J Clin Microbiol |
| ISSN: | 1098-660X |
| Popis: | Anaerobes are an important but uncommon cause of bloodstream infections (BSIs). For pediatric patients, routine inclusion of an anaerobic blood culture alongside the aerobic remains controversial. We implemented automatic anaerobic blood culture alongside aerobic blood cultures in a pediatric emergency department (ED) and sought to determine changes in recovery of obligate and facultative anaerobes. This was a cohort study in a pediatric ED (August 2015 to July 2018) that began in February 2017. Blood culture positivity results for true pathogens and contaminants were assessed, along with a secondary outcome of time to positivity (TTP) of blood culture. A total of 14,180 blood cultures (5,202 preimplementation and 8,978 postimplementation) were collected, with 8.8% (456) and 7.1% (635) positive cultures in the pre- and postimplementation phases, respectively. Of 635 positive cultures in the postimplementation phase, aerobic blood cultures recovered 7.6% (349/4,615), whereas anaerobic blood cultures recovered 6.6% (286/4,363). In 211/421 (50.0%) paired blood cultures, an organism was recovered in both cultures. The number of cases where organisms were only recovered from an aerobic or an anaerobic bottle in the paired cultures were 126 (30.0%) and 84 (20.0%), respectively. The TTP was comparable regardless of bottle type. Recovery of true pathogens from blood cultures was approximately 7 h faster than recovery of contaminants. Although inclusion of anaerobic blood cultures only recovered 2 (0.69%) obligate anaerobes, it did allow for recovery of clinically significant pathogens that were negative in aerobic blood cultures and supports the routine collection of both bottles in pediatric patients with a concern of bloodstream infections. |
| Databáze: | OpenAIRE |
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