miércoles, 19 de septiembre de 2018

Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia. - PubMed - NCBI

Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia. - PubMed - NCBI



 2017 Sep;140(3). pii: e20171013. doi: 10.1542/peds.2017-1013. Epub 2017 Aug 23.

Utility of Blood Culture Among Children Hospitalized With Community-Acquired Pneumonia.

Abstract

BACKGROUND AND OBJECTIVES:

National guidelines recommend blood cultures for children hospitalized with presumed bacterial community-acquired pneumonia (CAP) that is moderate or severe. We sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with CAP.

METHODS:

We conducted a cross-sectional study of children hospitalized with CAP in 6 children's hospitals from 2007 to 2011. We included children 3 months to 18 years of age with discharge diagnosis codes for CAP using a previously validated algorithm. We excluded children with complex chronic conditions. We reviewed microbiologic data and classified positive blood culture detections as pathogens or contaminants. Antibiotic-susceptibility patterns were assessed for all pathogens.

RESULTS:

A total of 7509 children hospitalized with CAP were included over the 5-year study period. Overall, 34% of the children hospitalized with CAP had a blood culture performed; 65 (2.5% of patients with blood cultures; 95% confidence interval [CI]: 2.0%-3.2%) grew a pathogen. Streptococcus pneumoniae accounted for 78% of all detected pathogens. Among detected pathogens, 50 (82%) were susceptible to penicillin. Eleven children demonstrated growth of an organism nonsusceptible to penicillin, representing 0.43% (95% CI: 0.23%-0.77%) of children with blood cultures obtained and 0.15% (95% CI: 0.08%-0.26%) of all children hospitalized with CAP.

CONCLUSIONS:

Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.

PMID:
 
28835382
 
PMCID:
 
PMC5574722
 
DOI:
 
10.1542/peds.2017-1013

[Indexed for MEDLINE] 
Free PMC Article

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