Abstract

Objective: Fever is a significant presenting complaint in pediatric emergency services. Blood stream infections have high morbidity and mortality rates, especially in young children and newborns. Blood cultures are the gold standard to determine the agent. Although there are many studies on hospitalized patients, no published data are available on the utility of blood cultures in a pediatric emergency department from our country. We conducted this study to evaluate the distribution of microorganisms isolated from blood cultures sent from a university pediatric emergency department and to evaluate the usage of blood cultures and antibiotic choice.

Material and Methods: This retrospective study included 10642 blood cultures that were sent to the Clinical Microbiology Laboratory of Ankara University Faculty of Medicine between January 2011 and December 2012 by the Pediatric Emergency Department of the same university.

Results: During the study period, 10642 blood cultures were evaluated at the Clinical Microbiology Laboratory. There was no growth in 10018 (94.2%) samples and 585 (93.7%) samples were considered to be contaminated. Various bacteria were determined in 624 (5.8%) samples; 91.7% (n=573) were Gram positive and 8.3% (n=51) were Gram negative. 58.2% (n=363) of the isolated microorganism consisted of coagulase-negative staphylococci and 19.8% (n=72) were resistant to methicillin. S. pneumonia (n= 11), S. aureus (n=10) and Enterococcus (n=7) were also isolated from blood cultures. Glucopeptide resistance was not found in the Staphylococcus and Enterococcus isolates. E. coli was isolated in three samples and ESBL were positive in two of these strains

Keywords: Fever, Bacteremia, Pediatric emergency, Blood cultures

References

  1. Weinstein MP. Current blood culture methods and systems: Clinical concepts, technology, and interpretation of results. Clin Infect Dis 1996;23:40-6.
  2. Balıkçı A, Belas Z, Eren Topkaya A. Kan kültürü pozitifliği: Etken ya da kontaminasyon mu? Mikrobiyolji Bul 2013;47:135-40.
  3. Bressan S, Berlese P, Mion T, Masiero S, Cavallaro A, Da Dalt L. Bacteremia in feverish children presenting to the emergency department: A retrospective study and literature review. Acta Paediatr 2012;101:271-7.
  4. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788-802.
  5. Kuppermann N. Occult bacteremia in young febrile children. Pediatr Clin North Am 1999;46:1073-109.
  6. Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing teSM-SW, PA: Clinical Laboratory Standards Institute; 2009.
  7. Gülmez D, Gür D. Hacettepe Üniversitesi İhsan Doğramacı Çocuk Hastanesi’nde 2000-2011 yılları arasında kan kültürlerinden izole edilen mikroorganizmalar: 12 yıllık değerlendirme. J Pediatr Inf 2012;6:79-83.
  8. Mehli M, Gayyurhan ED, Zer Y, Akgün S, Özgür Akın FE, Balcı İ. Gaziantep Üniversitesi Tıp Fakültesi Hastanesi’nde kan kültrülerinden izole edilen mikro-organizmalar ve antibiyotik duyarlılıkları. İnfeksiyon Dergisi 2007;21:141-5.
  9. Çopur Çiçek A, Şentürk Köksal Z, Ertürk A, Köksal E. Rize 82. Yıl Devlet Hastanesi’nde bir yıllık sürede kan kültürlerinden izole edilen mikroorganizmalar ve antibiyotiklere duyarlılıkları. Turk Hij Den Biyol Derg 2011;68:175-4.
  10. Sevim S, Öztürk Ş, Coşkuner A, Özgenç O, Avcı M. Bactec Kan Kültürü Sistemi ile izole edilen mikro-organizmaların değerlendirilmesi. İnfeksiyon Dergisi 2007;21:135-40.
  11. ren hekim tarafından yapıldığı için kan kültürü alınması için stan
  12. dart bir endikasyon yoktur. Acilde hasta yükünün çok olması,
  13. Isaacman DJ, McIntosh ED, Reinert RR. Burden of invasive pneumococcal disease and serotype distribution among Streptococcus pneumoniae isolates in young children in Europe: Impact of the 7-valent pneumococcal conjugate vaccine and considerations for future conjugate vaccines. Int J Infect Dis 2010;14:e197-209.
  14. Myers C, Gervaix A. Streptococcus pneumoniae bacteraemia in children. Int J Antimicrob Agents 2007;30 Suppl 1:S24-8.
  15. Gültekin B, Eyigör M, Telli M, Aksoy M, Aydın N. Yedi yıllık dönemde kan kültürlerinden izole edilen candida türlerinin retrospektif olarak incelenmesi. ANKEM Derg 2010;24:202-8.
  16. Jones RN, Marshall SA, Pfaller MA, Wilke WW, Hollis RJ, Erwin ME, et al. Nosocomial enterococcal blood stream infections in the SCOPE Program: Antimicrobial resistance, species occurrence, molecular testing results, and laboratory testing accuracy. Diagn Microbiol Infect Dis 1997;29:95-102.
  17. Hall RT, Domenico HJ, Self WH, Hain PD. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. Pediatrics 2013;131:e292-7.
  18. Weddle G, Jackson MA, Selvarangan R. Reducing blood culture contamination in a pediatric emergency department. Pediatric emergency care 2011;27:179-81.

Copyright and license

How to cite

1.
Oğuz S, Kurt F, Korkmaz V, Tekin D, Suskan E. Utilization of Blood Cultures in the Pediatric Emergency Department. Turk J Pediatr Dis [Internet]. 2016 Dec. 1 [cited 2025 May 24];10(4):265-9. Available from: https://turkjpediatrdis.org/article/view/368