Role of blood culture in critically sick paediatric patients and  its clinical impact: a tertiary care hospital based study

Khurshid Wani; Imran Gattoo; Kaiser Ahmed; Wasim Qadir

doi:10.18203/2320-6012.ijrms20150292

Authors

Khurshid Wani Associate Professor, Post Graduate department of Paediatrics, Government Medical College Srinagar J&K
Imran Gattoo Registrar, Post graduate department of Paediatrics, Government Medical College Srinagar J&K
Kaiser Ahmed Department of Microbiology, Post Graduate Department of Pediatrics, Government Medical College Srinagar J&K
Wasim Qadir Department of Microbiology, Post Graduate Department of Pediatrics, Government Medical College Srinagar J&K

DOI:

https://doi.org/10.18203/2320-6012.ijrms20150292

Keywords:

Blood culture, Clinical impact, Septicaemia, Bacteraemia

Abstract

Background: Blood cultures form a critical part of evaluation of patients with suspected sepsis. The present study was undertaken to study the risk factors, duration of incubation for obtaining positive cultures, and the clinical impact of the culture report.

Methods: A total of 224 samples from 110 critically sick pediatric patients presenting with suspected bacteraemia were processed aerobically.

Results: Cultures were positive in 25.45% of the Patients. Most of the positive cultures were obtained after 24 hours of incubation of the broth and no isolates were obtained beyond day 4 of incubation. Therapy was modified in 52.73% of the patients after receipt of culture report.

Conclusions: Incubation beyond four days (unless with specific indication like enteric fever) may be unnecessary for issuing a negative culture report. Repeated isolation of doubtful pathogens confirms true bacteraemia. Early culture report increases therapeutic compliance.

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References

Yagupsky P, Nolte FS. Quantitative aspects of septicaemia. Clin Microbiol Rev. 1990;3:269-79.

Philips SE, Bradley JS. Bactaeraemia detected by lysis direct plating in a neonatal intensive care unit. J Clin Microbiol. 1990;28:1-4.

Arbo MD, Snydman DR. Influence of blood culture results on antibiotic choice in the treatment of bacteraemia. Arch Intern Med. 1994;154:2641-5.

Doern GV, Brueggemann AB, Dunne WM, Jenkins SG, Halstead DC, McLaughlin JC. Four-day incubation period for blood culture bottles processed with the Difco ESP blood culture system. J Clin Microbiol. 1997;35:1290-2.

Leisure MK, More DM, Schwartzman JD, Hayden GF, Donowitz LG. Changing the needle when inoculating blood cultures: A no-benefit and high-risk procedure. JAMA. 1990;264:2111-2.

Washington JA 2 nd. Blood cultures: Principles and techniques. Mayo Clin Proc. 1975;50:91-8.

Reimer LG, Wilson ML, Weinstein MP. Update on detection of bacteraemia and fungaemia. Clin Microbiol Rev. 1997;10:445-65.

Aranson MD, Bor DH. Diagnostic decision: Blood cultures. Ann Intern Med. 1987;106:246-53.

Bates DW, Goldman L, Lee TH. Contaminant blood cultures and resource utilization: The true consequences of false-positive results. JAMA. 1991;265:365-9.

Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of neonatal septicaemia in a tertiary care hospital of Northern India. Indian J Med Microbiol. 2002;20:156-9.

Roberts FJ, Geere IW, Coldman A. A Three-year study of positive blood cultures with emphasis on prognosis. Reviews Infect Dis. 1991;13:34-46.

Weems J Jr. The many faces of Staphylococcus aureus infection. Postgrad Med. 2002;3:33-41.

Chakrabarti A, Singh K, Das S. Changing face of nosocomial candidaemia. Indian J Med Microbiol. 1999;17:160-6.

Rao S, Ali U. Systemic fungal infections in neonates. J Postgrad Med. 2005;51:527-9.

Singhi SC, Reddy TC, Chakrabarty A. Oral Itraconazole in the treatment of candidaemia in a pediatric intensive care unit. Indian J Pediatr. 2004;71:973-7.

Reller LB, Murray PR, MacLowry JD. Cumitech IA. Blood cultures II. Coordinating ed, J A Washington II. American Society of Microbiology, Washington DC; 1982.

Vinod Kumar CS, NeelaGaud YF. Incubation period for culture positivity to detect septicaemia in neonates: Correspondence. Indian J Med Microbiol. 2005;23:270-1.

Trenholme GM, Raymond LK, Karakusis PH, Stine T, Fuhrer J, Landau W, et al. Clinical impact of rapid identification and susceptibility testing of bacterial blood culture isolates. J Clin Microbiol. 1989;27:1342-5.