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

Neuman MI, Hall M, Lipsett SC, Hersh AL, Williams DJ, Gerber JS, Brogan TV, Blaschke AJ, Grijalva CG, Parikh K, Ambroggio L, Shah SS, Pediatric Research in Inpatient Settings Network
Pediatrics. 2017 140 (3)

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

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. 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.

Copyright © 2017 by the American Academy of Pediatrics.

MeSH Terms (18)

Adolescent Anti-Bacterial Agents Bacteremia Bacteria Blood Culture Child Child, Preschool Community-Acquired Infections Cross-Sectional Studies Female Hospitalization Humans Infant Male Microbial Sensitivity Tests Penicillins Pneumonia, Bacterial Retrospective Studies

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