Chapter 8 : Pediatric Blood Cultures

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In pediatrics as in adult medicine, the clinical microbiology laboratory plays an integral role in providing accurate and timely data to aid in the diagnosis, treatment, and monitoring of various infectious diseases. Because of the associated morbidity and mortality with bloodstream infection (BSI), blood cultures are among the most critical diagnostic tests in pediatric laboratory medicine. Despite the critical nature of the pediatric blood culture, there remains a great deal of myth and misunderstanding surrounding these cultures. The unique challenges associated with pediatric blood cultures include the wide range of patient blood volumes making one standard recommended culture volume impossible, an ever evolving epidemiology of sepsis due in large part to the availability of various vaccines, and a diverse range of clinical presentations due to the dynamic patient population, ranging from neonates through the late teenage years. This chapter focuses on these uniquely pediatric challenges.

Citation: Revell P, Doern C. 2017. Pediatric Blood Cultures, p 151-162. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch8
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Figure 1

Examples of weight- and age-based blood volume recommendations for pediatric blood cultures.

Citation: Revell P, Doern C. 2017. Pediatric Blood Cultures, p 151-162. In Dunne, Jr. W, Burnham C (ed), The Dark Art of Blood Cultures. ASM Press, Washington, DC. doi: 10.1128/9781555819811.ch8
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1. Verani JR,, McGee L,, Schrag SJ, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). 2010. Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep 59(RR-10):136.
2. Anonymous. 1991. Haemophilus b conjugate vaccines for prevention of Haemophilus influenzae type b disease among infants and children two months of age and older. Recommendations of the immunization practices advisory committee (ACIP). MMWR Recomm Rep 40(RR-1):17.
3. Cantey JB,, Farris AC,, McCormick SM. 2016. Bacteremia in early infancy: etiology and management. Curr Infect Dis Rep 18:1.
4. Biondi E,, Evans R,, Mischler M,, Bendel-Stenzel M,, Horstmann S,, Lee V,, Aldag J,, Gigliotti F. 2013. Epidemiology of bacteremia in febrile infants in the United States. Pediatrics 132:990996.
5. Mischler M,, Ryan MS,, Leyenaar JK,, Markowsky A,, Seppa M,, Wood K,, Ren J,, Asche C,, Gigliotti F,, Biondi E. 2015. Epidemiology of bacteremia in previously healthy febrile infants: a follow-up study. Hosp Pediatr 5:293300.
6. Greenhow TL,, Hung YY,, Herz AM. 2012. Changing epidemiology of bacteremia in infants aged 1 week to 3 months. Pediatrics 129:e590e596.
7. Greenhow TL,, Hung YY,, Herz AM,, Losada E,, Pantell RH. 2014. The changing epidemiology of serious bacterial infections in young infants. Pediatr Infect Dis J 33:595599.
8. Bizzarro MJ,, Raskind C,, Baltimore RS,, Gallagher PG. 2005. Seventy-five years of neonatal sepsis at Yale: 1928-2003. Pediatrics 116:595602.
9. Gomez B,, Hernandez-Bou S,, Garcia-Garcia JJ,, Mintegi S, Bacteraemia Study Working Group from the Infectious Diseases Working Group, Spanish Society of Pediatric Emergencies (SEUP). 2015. Bacteremia in previously healthy children in emergency departments: clinical and microbiological characteristics and outcome. Eur J Clin Microbiol Infect Dis 34:453460.
10. Sard B,, Bailey MC,, Vinci R. 2006. An analysis of pediatric blood cultures in the postpneumococcal conjugate vaccine era in a community hospital emergency department. Pediatr Emerg Care 22:295300.
11. Campos JM. 1989. Detection of bloodstream infections in children. Eur J Clin Microbiol Infect Dis 8:815824.
12. Kellogg JA,, Ferrentino FL,, Goodstein MH,, Liss J,, Shapiro SL,, Bankert DA. 1997. Frequency of low level bacteremia in infants from birth to two months of age. Pediatr Infect Dis J 16:381385.
13. Kellogg JA,, Manzella JP,, Bankert DA. 2000. Frequency of low-level bacteremia in children from birth to fifteen years of age. J Clin Microbiol 38:21812185.
14. Isaacman DJ,, Karasic RB,, Reynolds EA,, Kost SI. 1996. Effect of number of blood cultures and volume of blood on detection of bacteremia in children. J Pediatr 128:190195.
15. Connell TG,, Rele M,, Cowley D,, Buttery JP,, Curtis N. 2007. How reliable is a negative blood culture result? Volume of blood submitted for culture in routine practice in a children’s hospital. Pediatrics 119:891896.
16. Gonsalves WI,, Cornish N,, Moore M,, Chen A,, Varman M. 2009. Effects of volume and site of blood draw on blood culture results. J Clin Microbiol 47:34823485.
17. Marlowe L,, Mistry RD,, Coffin S,, Leckerman KH,, McGowan KL,, Dai D,, Bell LM,, Zaoutis T. 2010. Blood culture contamination rates after skin antisepsis with chlorhexidine gluconate versus povidone-iodine in a pediatric emergency department. Infect Control Hosp Epidemiol 31:171176.
18. McGowan KL,, Foster JA,, Coffin SE. 2000. Outpatient pediatric blood cultures: time to positivity. Pediatrics 106:251255.
19. Riedel S,, Bourbeau P,, Swartz B,, Brecher S,, Carroll KC,, Stamper PD,, Dunne WM,, McCardle T,, Walk N,, Fiebelkorn K,, Sewell D,, Richter SS,, Beekmann S,, Doern GV. 2008. Timing of specimen collection for blood cultures from febrile patients with bacteremia. J Clin Microbiol 46:13811385.
20. Kee PP,, Chinnappan M,, Nair A,, Yeak D,, Chen A,, Starr M,, Daley AJ,, Cheng AC,, Burgner D. 2016. Diagnostic yield of timing blood culture collection relative to fever. Pediatr Infect Dis J 35:846850.
21. Doern CD,, Mirrett S,, Halstead D,, Abid J,, Okada P,, Reller LB. 2014. Controlled clinical comparison of new pediatric medium with adsorbent polymeric beads (PF Plus) versus charcoal-containing PF medium in the BacT/alert blood culture system. J Clin Microbiol 52:18981900.
22. Staneck JL,, Vincent S. 1981. Inhibition of Neisseria gonorrhoeae by sodium polyanetholesulfonate. J Clin Microbiol 13:463467.
23. Rintala L,, Pollock HM. 1978. Effects of two blood culture anticoagulants on growth of Neisseria meningitidis. J Clin Microbiol 7:332336.
24. Wilkins TD,, West SE. 1976. Medium-dependent inhibition of Peptostreptococcus anaerobius by sodium polyanetholsulfonate in blood culture media. J Clin Microbiol 3:393396.
25. Rosner R. 1975. Comparison of recovery rates of various organisms from clinical hypertonic blood cultures by using various concentrations of sodium polyanethol sulfonate. J Clin Microbiol 1:129131.
26. Freedman SB,, Roosevelt GE. 2004. Utility of anaerobic blood cultures in a pediatric emergency department. Pediatr Emerg Care 20:433436.
27. Dunne WM Jr,, Tillman J,, Havens PL. 1994. Assessing the need for anaerobic medium for the recovery of clinically significant blood culture isolates in children. Pediatr Infect Dis J 13:203206.
28. Zaidi AK,, Knaut AL,, Mirrett S,, Reller LB. 1995. Value of routine anaerobic blood cultures for pediatric patients. J Pediatr 127:263268.
29. Campigotto A,, Richardson SE,, Sebert M,, McElvania TeKippe E,, Chakravarty A,, Doern CD. 2016. Low utility of pediatric isolator blood culture system for detection of fungemia in children: a 10-year review. J Clin Microbiol 54:22842287.
30. Dankner WM,, Spector SA,, Fierer J,, Davis CE. 1987. Malassezia fungemia in neonates and adults: complication of hyperalimentation. Rev Infect Dis 9:743753.
31. Carter K,, Doern C,, Jo CH,, Copley LA. 2016. The clinical usefulness of polymerase chain reaction as a supplemental diagnostic tool in the evaluation and the treatment of children with septic arthritis. J Pediatr Orthop 36:167172.
32. Yagupsky P. 2004. Kingella kingae: from medical rarity to an emerging paediatric pathogen. Lancet Infect Dis 4:358367.
33. Yagupsky P,, Dagan R,, Howard CW,, Einhorn M,, Kassis I,, Simu A. 1992. High prevalence of Kingella kingae in joint fluid from children with septic arthritis revealed by the BACTEC blood culture system. J Clin Microbiol 30:12781281.

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