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Noh GY, Park YS, Kim SH, Song SA, Shin JH. Clinical usefulness of anaerobic blood culture in pediatric patients with bacteremia. Anaerobe 2023; 84:102804. [PMID: 37993055 DOI: 10.1016/j.anaerobe.2023.102804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/23/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES The purpose of this study is to evaluate the usefulness of anaerobic blood culture in pediatric patients by comparing the detection rate and distribution of bacteria between aerobic and anaerobic blood culture bottles. METHODS A retrospective analysis was conducted on 11,664 blood cultures obtained from children under the age of 14 between January 2013 and June 2020. The positive rate of total, aerobic, and anaerobic blood culture, as well as the species distribution of each blood culture bottle, were investigated. RESULTS The positive rate of blood culture was 2.4 % (N = 281). Among them, 67 (23.8 %), 85 (30.3 %) and 129 (45.9 %) organisms were grown in only aerobic, only anaerobic, and both blood culture bottles, respectively. Gram-positive cocci were cultured on both, only aerobic, and only anaerobic blood culture bottles in proportions of 46.4 %, 23.4 %, and 30.2 %, respectively. Gram-negative bacilli were cultured on both, only aerobic, and only anaerobic blood culture bottles in proportions of 58.5 %, 12,3 %, and 29.2 %, respectively. Gram-positive bacilli grew best in aerobic bottle only. There were seven strains of obligate anaerobes. CONCLUSION Because many facultative anaerobic bacteria are recognized primarily from anaerobic blood culture bottles, combining aerobic and anaerobic blood culture bottles might be beneficial in pediatric patients with suspected blood stream infection.
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Affiliation(s)
- Ga Young Noh
- Inje University College of Medicine, Busan, Republic of Korea
| | - Yoon Soo Park
- Inje University College of Medicine, Busan, Republic of Korea
| | - Si Hyun Kim
- Department of Clinical Laboratory Science, Semyung University, Jecheon, Republic of Korea
| | - Sae Am Song
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Republic of Korea
| | - Jeong Hwan Shin
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Republic of Korea; Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea.
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Farfour E, Le Brun C, Mizrahi A, Bargain P, Durieux MF, Boquel F, Corvec S, Jeddi F, Muggeo A, Huguenin A, Barraud O, Amara M, Fihman V, Bailly E, Botterel F, Guillard T, Vasse M. Contribution of the anaerobic blood culture vial for the recovery of Candida glabrata: a retrospective multicentric study. Med Mycol 2022; 60:6566345. [DOI: 10.1093/mmy/myac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/01/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Although Candida spp are aerobic microorganisms, some Candida strains, mainly Candida glabrata, can be recovered from anaerobic blood culture vials. We assessed the contribution of the anaerobic vials for the diagnosis of candidemia, especially for C. glabrata. We conducted a multicenter retrospective study including eight University or regional hospitals. A single episode of monomicrobial candidemia per patient was included from September 1st, 2016, to August 31st, 2019. The characteristics of all aerobic and anaerobic blood culture vials sampled within 2 hours before and after the first positive blood culture vials were recorded (type of vials, result, and for positive vials time-to-positivity and Candida species). Overall, 509 episodes of candidemia were included. The main species were C. albicans (55.6%) followed by C. glabrata (17.1%), C. parapsilosis (4.9%), and C. tropicalis (4.5%). An anaerobic vial was positive in 76 (14.9%) of all episodes of which 56 (73.8%) were due to C. glabrata. The number of C. glabrata infections only positive in anaerobic vials was 1 (2.6%), 1 (11.1%), and 15 (37.5%) with the BACT/ALERT 3D the BACT/ALERT VIRTUO and the BACTEC FX instrument respectively (P < 0.01). The initial positivity of an anaerobic vial was highly predictive of the isolation of C. glabrata with the BACTEC FX (sensitivity of 96.8%). C. glabrata time-to-positivity was shorter in anaerobic vial than aerobic vial with all instruments. Anaerobic blood culture vials improve the recovery of Candida spp mainly C. glabrata. This study could be completed by further analyzes including mycological and pediatric vials.
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Affiliation(s)
- Eric Farfour
- Service de biologie clinique, Hôpital Foch, Suresnes, France
| | | | - Assaf Mizrahi
- Service de biologie, GH Paris Saint-Joseph, Paris, France
| | - Pauline Bargain
- Service de biologie, Hôpital A. Mignot, Le Chesnay-Rocquencourt, France
| | | | - Frédérique Boquel
- Unité de parasitologie-mycologie, Département de Prévention, diagnostic et traitement des infections. CHU Henri Mondor, APHP, Créteil, France
| | - Stéphane Corvec
- Service de Bactériologie et des contrôles microbiologiques des produits de santé, CHU de Nantes, Nantes, France
| | - Fakhri Jeddi
- Laboratoire de Parasitologie et Mycologie Médicale, CHU de Nantes, France
| | - Anaëlle Muggeo
- Université de Reims-Champagne-Ardenne, SFR CAP-Santé, Inserm UMR-S 1250 P3Cell, 51097, Reims, France; CHU Reims, Hôpital Robert Debré, France
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière-Parasitologie-Mycologie, 51100, Reims, France
| | - Antoine Huguenin
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière-Parasitologie-Mycologie, 51100, Reims, France
- EA 7510, ESCAPE, Laboratoire de Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, 51 rue Cognacq Jay, 51092 Reims CEDEX, France
| | - Olivier Barraud
- Service de bactériologie- virologie-hygiène, CHU Limoges, Limoges, France
| | - Marlène Amara
- Service de biologie, Hôpital A. Mignot, Le Chesnay-Rocquencourt, France
| | - Vincent Fihman
- Bacteriology and Infection control Unit, Department of Prevention, Diagnosis, and Treatment of Infections, Henri-Mondor University Hospital, AP-HP, 94000 Créteil, France
- EA 7380 Dynamyc, EnvA, UPEC, Paris-Est University, Créteil, France
| | - Eric Bailly
- Service de Parasitologie-mycologie, CHU Bretonneau, Tours, France
| | - Françoise Botterel
- Unité de parasitologie-mycologie, Département de Prévention, diagnostic et traitement des infections. CHU Henri Mondor, APHP, Créteil, France
| | - Thomas Guillard
- Université de Reims-Champagne-Ardenne, SFR CAP-Santé, Inserm UMR-S 1250 P3Cell, 51097, Reims, France; CHU Reims, Hôpital Robert Debré, France
- Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière-Parasitologie-Mycologie, 51100, Reims, France
| | - Marc Vasse
- Service de biologie clinique, Hôpital Foch, Suresnes, France
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The Addition of Anaerobic Blood Cultures for Pediatric Patients with Concerns for Bloodstream Infections: Prevalence and Time to Positive Cultures. J Clin Microbiol 2020; 58:JCM.01844-19. [PMID: 32641400 DOI: 10.1128/jcm.01844-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/30/2020] [Indexed: 11/20/2022] Open
Abstract
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.
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Thé T, Curfman A, Burnham CAD, Hayes E, Schnadower D. Pediatric Anaerobic Blood Culture Practices in Industrialized Countries. J Appl Lab Med 2018; 3:553-558. [PMID: 31639724 DOI: 10.1373/jalm.2018.027128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Routine anaerobic blood culture collection in febrile children is controversial, as clinicians try to account for the severe but relative infrequency of anaerobic bacteremia. Furthermore, clinical and laboratory practice variation among institutions may lead to potentially inaccurate epidemiological data. Our goal was to assess blood culture practices in pediatric patients throughout an international network of hospitals in industrialized countries. METHODS We conducted a survey of current clinical and laboratory practice patterns in a convenience sample of international institutions participating in 6 pediatric emergency research networks in the US, Canada, Europe, Australia, and New Zealand. A lead clinician at each institution queried institutional practices from the emergency department, pediatric intensive care unit, and oncology medical directors. The microbiology director at each institution completed the laboratory survey. RESULTS Sixty-five of 160 (41%) invited institutions participated in the survey. Routine anaerobic blood cultures are collected in 30% of emergency departments, 30% of intensive care units, and 48% of oncology wards. Reasons for restricting anaerobic culture collection included concerns regarding blood volume (51%), low pretest probability (22%), and cost-effectiveness (16%). The most common reasons institutions allow for selectively obtaining anaerobic cultures are clinical suspicion (64%) and patients who are immunosuppressed (50%). The microbiology survey showed variation in systems, although most use the BACTEC™ culture system and MALDI-TOF for organism identification. CONCLUSIONS There is broad variation in anaerobic blood culture practices among a network of pediatric hospitals in industrialized countries.
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Affiliation(s)
- Tama Thé
- Division of Emergency Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO;
| | - Alison Curfman
- Division of Emergency Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Carey-Ann D Burnham
- Departments of Pathology and Immunology, Molecular Microbiology, and Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Ericka Hayes
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - David Schnadower
- Division of Emergency Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
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Mukhopadhyay S, Puopolo KM. Relevance of Neonatal Anaerobic Blood Cultures: New Information for an Old Question. J Pediatric Infect Dis Soc 2018; 7:e126-e127. [PMID: 29165632 DOI: 10.1093/jpids/pix095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/05/2017] [Indexed: 11/13/2022]
Affiliation(s)
- Sagori Mukhopadhyay
- Division of Neonatology, Children's Hospital of Philadelphia, and University of Pennsylvania Perelman School of Medicine
| | - Karen M Puopolo
- Division of Neonatology, Children's Hospital of Philadelphia, and University of Pennsylvania Perelman School of Medicine
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Messbarger N, Neemann K. Role of Anaerobic Blood Cultures in Neonatal Bacteremia. J Pediatric Infect Dis Soc 2018; 7:e65-e69. [PMID: 29165580 DOI: 10.1093/jpids/pix088] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 09/14/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND Evaluation for neonatal sepsis routinely includes performing both aerobic and anaerobic blood cultures despite our lack of knowledge of the true incidence of anaerobic bacteremia in this age group and the consequences of not performing these paired cultures. METHODS We performed a retrospective review of all blood cultures performed for neonates in a children's hospital. Clinically significant pathogens were defined as microorganisms that rarely are considered to be contaminants, that were recovered from multiple blood cultures or sites, or were considered significant according to the patient's attending physician. The chart of every patient with positive culture results was reviewed for patient characteristics. RESULTS A total of 662 culture sets among 403 patients were obtained between November 1, 2013, and April 30, 2015. A clinically significant organism was isolated from 64 (9.7%) culture sets from 25 patients (1.9% contamination rate). A total of 56 organisms were isolated; 35 (62.5%) grew from both the aerobic and anaerobic bottles, 19 (33.9%) grew from the anaerobic bottle alone, and 2 (3.6%) grew from the aerobic bottle alone. One (0.2%) obligate anaerobic bacterium (Clostridium symbiosum) was identified. CONCLUSIONS Although the incidence of anaerobic bacteremia in neonates is rare, anaerobic culture remains important in this population, given the increased yield of both aerobic and facultative anaerobic organisms isolated from anaerobic blood culture bottles.
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Affiliation(s)
| | - Kari Neemann
- Department of Pediatrics, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha
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Gross I, Gordon O, Benenson S, Abu Ahmad W, Shimonov A, Hashavya S, Eventov-Friedman S. Using anaerobic blood cultures for infants younger than 90 days rarely showed anaerobic infections but increased yields of bacterial growth. Acta Paediatr 2018; 107:1043-1048. [PMID: 29405376 DOI: 10.1111/apa.14262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/13/2017] [Accepted: 01/30/2018] [Indexed: 11/29/2022]
Abstract
AIM The use of anaerobic blood cultures in infants suspected of bacteraemia is controversial. Our children's hospital uses both aerobic and anaerobic media, regardless of the risk of anaerobic infection, and the aim of this study was to re-evaluate the use of anaerobic cultures in infants. METHODS We collected retrospective data from 2002 to 2016 on all blood cultures taken from infants younger than 90 days in the Hadassah-Hebrew University Medical Centre, Jerusalem, Israel. The incidence and characteristics of infants with positive anaerobic blood cultures were assessed. RESULTS During the study period, 51 035 blood cultures were drawn from 44 304 infants. Of these, 1496 (2.9%) were clinically significant positive cultures. Pathogenic obligatory anaerobic bacteraemia was extremely rare, with only 37 positive cultures (0.07%) from all of the cultures drawn. No specific risk factors for obligatory anaerobic bacteraemia could be defined, but as many as 174 (11.6%) clinically significant isolates were only detected in the anaerobic culture bottle. CONCLUSION True anaerobic bacteraemia was extremely rare in neonates. Nevertheless, using anaerobic culture media may increase the overall yield of bacterial culture growth by isolating anaerobic-facultative bacteria. This should be weighed up against increasing the volume of blood used for the aerobic culture.
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Affiliation(s)
- Itai Gross
- Department of Paediatric; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Oren Gordon
- Department of Paediatric; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
- Department of clinical microbiology and Infectious Diseases; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Shmuel Benenson
- Department of clinical microbiology and Infectious Diseases; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Wiessam Abu Ahmad
- School of Public Health and Community Medicine; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Amir Shimonov
- Faculty of Medicine; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Saar Hashavya
- Department of Paediatric Emergency Medicine; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
| | - Smadar Eventov-Friedman
- Department of Neonatology; Hadassah and The Hebrew University Medical Centre; Jerusalem Israel
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8
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Abstract
BACKGROUND Anaerobic bacteremia is rare in children and current recommendations advocate against the routine use of anaerobic cultures in children. However, the incidence of anaerobic bacteremia and the utility of anaerobic blood cultures in children have not been assessed in recent years. Our pediatric emergency department (PED) policy still supports the use of both aerobic and anaerobic blood cultures in all cases of suspected bacteremia. This allowed us to re-evaluate the yield of anaerobic cultures in PED settings. METHODS Retrospective data of all blood cultures taken in the PED in a single tertiary center from 2002 to 2016 were collected. The incidence and characteristics of children with positive anaerobic blood cultures were assessed. Risk factors for anaerobic bacteremia were defined. RESULTS Of the 68,304 blood culture sets taken during the study period, 971 (1.42%) clinically significant positive cultures were found. Pathogenic obligatory anaerobic bacteria were isolated in 33 (0.05%) cultures. The leading risk factors for anaerobic bacteremia were head and neck abscess and intra-abdominal infection. Of all the true positive cultures, 187 (22%) were only detected in the anaerobic culture and would have otherwise been missed. CONCLUSIONS True anaerobic bacteremia is extremely rare in children admitted to the PED. Nevertheless, using anaerobic cultures may increase the overall yield of blood cultures.
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Judicious utilization of healthcare resources: reducing unindicated pediatric anaerobic blood cultures in a pediatric hospital. J Healthc Qual 2016; 37:199-204; quiz 204-5. [PMID: 26042628 DOI: 10.1097/01.jhq.0000462897.11646.61] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The decline in anaerobic infections in the past 15 years has resulted in healthcare professionals questioning the need for routine anaerobic blood cultures. In this study, we extracted baseline aerobic and anaerobic blood culture rates over the past 10 years (2001-2010) from our pediatric wards. A questionnaire survey of doctors was conducted to gather their views regarding anaerobic blood cultures. Interventions such as physician education were introduced over 6 months to reduce unindicated anaerobic blood cultures. Furthermore, the rates of blood cultures were tracked over time after intervention. Before intervention, 85% of doctors surveyed routinely ordered anaerobic blood cultures, 90% were unaware of any guidelines for anaerobic blood cultures, and 100% were unaware of the costs. The combination of physician education and restrictive interventions resulted in an 80% reduction in the number of anaerobic blood cultures performed and processed, which translated into savings of USD $2,883 per week, with projected savings of USD $145,560 annually.
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Monsonís Cabedo M, Rives Solá S, Noguera-Julian A, Urrea Ayala M, Cruz Martinez O, Gené Giralt A. Assessment of anaerobic blood cultures in pediatric oncology patients. Enferm Infecc Microbiol Clin 2016; 35:33-36. [PMID: 27221161 DOI: 10.1016/j.eimc.2016.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/15/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The routine use of a single aerobic bottle for blood culture in pediatric patients has become commonplace, as anaerobic bacteria are not frequently involved in clinically significant infections. The aim of this study was to assess the usefulness of routinely performing anaerobic blood cultures in pediatric oncology patients. METHODS Prospective study was conducted on pediatric (<18 years) patients affected with febrile syndrome after receiving chemotherapy for hematological or solid malignancies. Samples were inoculated into pediatric aerobic and standard anaerobic bottles (BacT/Alert automatic system). Strains were considered clinically significant, or deemed as contaminants, depending on isolation circumstances and clinical criteria. RESULTS A total of 876 blood cultures from 228 patients were processed during the 21-month study period (January 2014 to September 2015). Baseline diagnosis included 143 solid tumors and 67/18 cases of leukemia/lymphoma. Bacterial growth was detected in 90 (10.2%) blood cultures for 95 different isolates, of which 62 (7.1%)/63 isolates were considered clinically significant. Among the latter, 38 (60.3%) microorganisms grew in both aerobic and anaerobic bottles, 18 (28.6%) only in aerobic bottles, and 7 (11.1%) only in anaerobic bottles. Gram-negative bacilli (33; 52.4%), mainly from the Enterobacteriaceae family, were the most frequently isolated microorganisms. Overall, only 3 out of 90 isolates (3.3%) were strict anaerobes (Propionibacterium acnes), and all of them were deemed contaminants. CONCLUSION Strict anaerobes did not cause significant infections in febrile pediatric oncology patients, and anaerobic blood culture bottles offered no additional advantages over aerobic media. Our results suggest that routine blood cultures should be solely processed in aerobic media in this group of patients.
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Affiliation(s)
- Manuel Monsonís Cabedo
- Department of Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Susana Rives Solá
- Department of Haematology and Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Antoni Noguera-Julian
- Infectious Diseases Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Mireia Urrea Ayala
- Infections Control Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ofelia Cruz Martinez
- Department of Haematology and Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Amadeu Gené Giralt
- Department of Microbiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
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Hernández-Bou S, Álvarez Álvarez C, Campo Fernández M, García Herrero M, Gené Giralt A, Giménez Pérez M, Piñeiro Pérez R, Gómez Cortés B, Velasco R, Menasalvas Ruiz A, García García J, Rodrigo Gonzalo de Liria C. Blood cultures in the paediatric emergency department. Guidelines and recommendations on their indications, collection, processing and interpretation. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Hernández-Bou S, Álvarez Álvarez C, Campo Fernández MN, García Herrero MA, Gené Giralt A, Giménez Pérez M, Piñeiro Pérez R, Gómez Cortés B, Velasco R, Menasalvas Ruiz AI, García García JJ, Rodrigo Gonzalo de Liria C. [Blood cultures in the paediatric emergency department. Guidelines and recommendations on their indications, collection, processing and interpretation]. An Pediatr (Barc) 2015; 84:294.e1-9. [PMID: 26227314 DOI: 10.1016/j.anpedi.2015.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 06/17/2015] [Indexed: 12/11/2022] Open
Abstract
Blood culture (BC) is the gold standard when a bacteraemia is suspected, and is one of the most requested microbiological tests in paediatrics. Some changes have occurred in recent years: the introduction of new vaccines, the increasing number of patients with central vascular catheters, as well as the introduction of continuous monitoring BC systems. These changes have led to the review and update of different factors related to this technique in order to optimise its use. A practice guideline is presented with recommendations on BC, established by the Spanish Society of Paediatric Emergency Care and the Spanish Society for Paediatric Infectious Diseases. After reviewing the available scientific evidence, several recommendations for each of the following aspects are presented: BC indications in the Emergency Department, how to obtain, transport and process cultures, special situations (indications and interpretation of results in immunosuppressed patients and/or central vascular catheter carriers, indications for anaerobic BC), differentiation between bacteraemia and contamination when a BC shows bacterial growth and actions to take with a positive BC in patients with fever of unknown origin.
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Affiliation(s)
- S Hernández-Bou
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP).
| | | | - M N Campo Fernández
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP)
| | - M A García Herrero
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP)
| | - A Gené Giralt
- Servicio de Microbiología, Hospital Sant Joan de Déu, Barcelona, España
| | - M Giménez Pérez
- Servicio de Microbiología, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, España
| | | | - B Gómez Cortés
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP)
| | - R Velasco
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP)
| | | | - J J García García
- Grupo para el estudio de la bacteriemia, Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Urgencias de Pediatría (SEUP), Sociedad Española de Urgencias de Pediatría (SEUP)
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13
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Shoji K, Komuro H, Watanabe Y, Miyairi I. The utility of anaerobic blood culture in detecting facultative anaerobic bacteremia in children. Diagn Microbiol Infect Dis 2013; 76:409-12. [PMID: 23747032 DOI: 10.1016/j.diagmicrobio.2013.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/02/2013] [Accepted: 05/02/2013] [Indexed: 11/15/2022]
Abstract
Routine anaerobic blood culture is not recommended in children because obligate anaerobic bacteremia is rare in the pediatric population. However, a number of facultative anaerobic bacteria can cause community and hospital acquired infections in children and the utility of anaerobic blood culture for detection of these organisms is still unclear. We conducted a retrospective analysis of all blood culture samples (n = 24,356) at a children's hospital in Japan from October 2009 to June 2012. Among the samples that had paired aerobic and anaerobic blood cultures, 717 samples were considered clinically significant with 418 (58%) organisms detected from both aerobic and anaerobic cultures, 167 (23%) detected only from aerobic culture and 132 (18%) detected only from anaerobic culture. While most facultative anaerobes were detectable by aerobic culture, over 25% of Enterobacteriaceae and 15% of Staphylococcus sp. were detected from anaerobic cultures bottles only, suggesting its potential role in selected settings.
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Affiliation(s)
- Kensuke Shoji
- Department of Medical Subspecialties, Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan.
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14
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Hui M, Ho WH, Lam WH, Poon CS, Chu KC, Chan CY. Candida glabrata fungaemia: the importance of anaerobic blood culture. J Med Microbiol 2009; 58:396-397. [DOI: 10.1099/jmm.0.47842-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mamie Hui
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
| | - Wing-Han Ho
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
| | - Wai-Ho Lam
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
| | - Chi-Sing Poon
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
| | - Kai-Cheong Chu
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
| | - Chiu-Yeung Chan
- Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR
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Russell CM, Axon JE, Blishen A, Begg AP. Blood culture isolates and antimicrobial sensitivities from 427 critically ill neonatal foals. Aust Vet J 2008; 86:266-71. [DOI: 10.1111/j.1751-0813.2008.00311.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Hecht DW. Routine Anaerobic Blood Cultures: Back Where We Started? Clin Infect Dis 2007; 44:901-3. [PMID: 17342638 DOI: 10.1086/512440] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Accepted: 12/19/2006] [Indexed: 11/03/2022] Open
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McCaig LF, McDonald LC, Cohen AL, Kuehnert MJ. Increasing blood culture use at US hospital emergency department visits, 2001 to 2004. Ann Emerg Med 2007; 50:42-8, 48.e1-2. [PMID: 17383772 DOI: 10.1016/j.annemergmed.2006.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 11/21/2006] [Accepted: 12/05/2006] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE We describe emergency department (ED) visits in which patients had blood cultured and examine changes in blood culture use. METHODS Data from the 2001 to 2004 National Hospital Ambulatory Medical Care Survey, an annual sample survey of visits to US hospital EDs, were analyzed. About 400 EDs reported data for approximately 37,000 visits each year. Trends in blood culture use were examined among persons 3 months of age and older. Visits by admitted/transferred patients were compared to those released. RESULTS About 3.1 million blood cultures were ordered annually in US EDs; blood cultures were ordered at 2.8% of all visits. From 2001 through 2004, the proportion of visits where a blood culture was ordered increased by 33%, particularly in adults. The proportion of visits with a pneumonia diagnosis where a blood culture was ordered rose by 23% during the study period; these visits accounted for 22% of the increase in blood culture use among admitted patients. Almost half of blood cultures were ordered at visits in which the patient was released from the ED. For visits by released patients 3 years of age and older who had blood cultured, 43% had neither fever nor antibiotic prescriptions. CONCLUSION There is an increasing national trend in the use of blood cultures at adult patient ED visits; a large proportion of these cultures were for released patients without apparent indicators for bacteremia, such as fever or antibiotic prescriptions. Factors and impact associated with this dynamically changing practice need further evaluation.
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Affiliation(s)
- Linda F McCaig
- Ambulatory Care Statistics Branch, Division of Health Care Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
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Abstract
PURPOSE This review discusses recent literature that has focused on the epidemiology, clinical and laboratory evaluation and treatment of episodes of acute illnesses associated with fever and also of prolonged episodes of fever in children. RECENT FINDINGS Articles addressed the epidemiology of invasive pneumococcal disease in children in other countries that have not yet initiated vaccination with the conjugated pneumococcal vaccine. From the United States there was a report of the decreased occurrence of invasive pneumococcal disease in patients being provided primary care who had been vaccinated with conjugated pneumococcal vaccine. Another report outlined the experience at children's hospitals with invasive pneumococcal disease in the years pre- and post-introduction of pneumococcal vaccine. One of the studies found that there was a slight increase in pneumococcal disease caused by non-vaccine serotypes. Another group of articles focused on serious bacterial infections in infants with fever who are positive for respiratory syncytial virus (RSV). All studies found a significant occurrence of urinary tract infections in these patients. One report found that bacteremia may occur in such patients if less than 28 days of age. Finally articles from Turkey, Thailand, and Italy give excellent discussions about the range of diagnoses and key clinical findings that may be seen in children with prolonged fever. SUMMARY In the review period, there was a particular emphasis on invasive disease caused by S. pneumoniae and the impact of vaccination with conjugated pneumococcal vaccine, on the occurrence of serious bacterial infection in febrile infants with RSV infections, and on the broad spectrum of diagnoses in children with prolonged fever in varying geographic locales.
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Affiliation(s)
- Paul McCarthy
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA.
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