Time to positivity of blood cultures in paediatric patients.

IF 1.6 4区医学 Q2 PEDIATRICS

Journal of paediatrics and child health Pub Date : 2024-10-23 DOI:10.1111/jpc.16707

Catrin Kar Yee Kong, Natalie Woon Hui Tan, Karen Donceras Nadua, Kai-Qian Kam, Jiahui Li, Koh Cheng Thoon, Chee Fu Yung, Matthias Maiwald, Chia Yin Chong

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引用次数: 0

Abstract

Aim: Continuous monitoring of blood culture (BC) systems allows rapid detection of microbial growth. We aimed to determine differences in time to positivity (TTP) in BACTEC BC between organisms and whether a 36-h period was sufficient to detect all relevant pathogenic bacteria for children admitted to a tertiary care paediatric hospital.

Methods: This was a retrospective audit of positive aerobic (AE) and anaerobic (AN) BC from paediatric inpatients with available TTP from 1 August 2016 to 2 January 2019. First positive BC per bacteraemia episode was analysed.

Results: Overall, 649 BC were positive, of which 480 first positive BC were analysed: 246 AE (51.3%) only, 216 paired (45%) (108 AE and 108 AN) and 18 AN (3.8%) only. There were 372 episodes of bacteraemia in 340 patients. Median age was 19 months (interquartile range (IQR): 1.25-60). Median TTP for AE and AN cultures was 13.20 (IQR: 9.84-18.48) and 13.92 h (IQR: 10.32-17.04), respectively. Organisms were GNR 49.7%, GPC 29.6%, contaminants 14.5%, mixed 3.0%, other 2.4% and yeast 0.8%. Streptococcus agalactiae had the fastest median TTP in AE and AN cultures, followed by Escherichia coli (AE 8.88 vs. 10.20 h). For paired AE and AN cultures, TTP was faster for AE versus AN cultures (13.36 vs. 14.52 h, P = 0.001). A 36-h cut-off time captured 97.7% AE BC and 99.1% AN BC with pathogens, and 86.5% AE BC and 91.7% AN BC with contaminants, respectively.

Conclusions: GNR were the commonest pathogens in paediatric BC and faster growth was detected in AE versus AN cultures. By 36 h, >97.7% of BC were positive for pathogens versus 86.5% for contaminants.

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儿科病人血液培养阳性的时间。

目的：对血液培养（BC）系统进行连续监测可快速检测微生物的生长情况。我们的目的是确定 BACTEC BC 不同菌种阳性时间（TTP）的差异，以及 36 小时是否足以检测出一家三级儿科医院收治的所有相关病原菌：这是对2016年8月1日至2019年1月2日期间儿科住院患者需氧菌（AE）和厌氧菌（AN）BC阳性病例的回顾性审核，并提供了TTP。分析了每一例菌血症首次出现的需氧菌和厌氧菌阳性病例：共分析了 649 例 BC 阳性病例，其中 480 例 BC 首次阳性病例：246 例 AE（51.3%），216 例配对病例（45%）（108 例 AE 和 108 例 AN），18 例 AN（3.8%）。340 名患者共发生了 372 次菌血症。中位年龄为 19 个月（四分位数间距 (IQR)：1.25-60）。AE和AN培养的中位TTP分别为13.20小时（IQR：9.84-18.48）和13.92小时（IQR：10.32-17.04）。微生物种类为 GNR 49.7%、GPC 29.6%、污染物 14.5%、混合 3.0%、其他 2.4% 和酵母菌 0.8%。在 AE 和 AN 培养物中，半乳链球菌的中位 TTP 最快，其次是大肠埃希菌（AE 8.88 小时对 10.20 小时）。在成对的 AE 和 AN 培养物中，AE 培养物的 TTP 快于 AN 培养物（13.36 对 14.52 小时，P = 0.001）。36小时的截止时间分别捕获了97.7%的AE BC和99.1%的AN BC病原体，以及86.5%的AE BC和91.7%的AN BC污染物：GNR 是儿科 BC 中最常见的病原体，在 AE 和 AN 培养物中检测到的生长速度更快。在 36 小时内，>97.7% 的 BC 病原体呈阳性，而 86.5% 的 BC 污染物呈阳性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of paediatrics and child health 医学-小儿科

CiteScore

2.90

自引率

5.90%

发文量

487

审稿时长

3-6 weeks

期刊介绍： The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.