Time-to-Positivity of Blood Cultures in Children With Sepsis
Alexa Dierig, Christoph Berger, Philipp K A Agyeman, Sara Bernhard-Stirnemann, Eric Giannoni, Martin Stocker, Klara M Posfay-Barbe, Anita Niederer-Loher, Christian R. Kahlert, Alex Donas, Paul Hasters, Christa Relly, Thomas Riedel, Christoph Aebi, Luregn J Schlapbach, Ulrich Heininger & Swiss Pediatric Sepsis Study
|
abstract
|
Blood cultures are essential for the diagnosis and further
appropriate treatment in children with suspected sepsis. In most
hospitals, children will be empirically treated or closely monitored
for at least 48 h awaiting results of blood cultures. Several
studies have challenged the optimal duration of empiric treatment in
the era of continuously monitored blood culture systems. The aim of
our study was to investigate time-to-positivity (TTP) of blood
cultures in children with proven sepsis. The Swiss Pediatric Sepsis
Study prospectively enrolled children 0-16 years of age with blood
culture positive sepsis between September 2011 and October 2015. TTP
was prospectively assessed in six participating academic pediatric
hospitals by fully automated blood culture systems. In 521 (93%) of
562 bacteremia episodes (493 children, median age 103 days, range 0
days-16.9 years) a valid TTP was available. Median TTP was 12 h (IQR
8-17 h, range 0-109 h). By 24, 36, and 48 h, 460 (88%), 498 (96%),
and 510 (98%) blood cultures, respectively, were positive. TTP was
independent of age, sex, presence of comorbidities, site of
infection and severity of infection. Median TTP in all age groups
combined was shortest for group B streptococcus (8.7 h) and longest
for coagulase-negative staphylococci (16.2 h). Growth of bacteria
in blood cultures is detectable within 24 h in 9 of 10 children with
blood culture-proven sepsis. Therefore, a strict rule to observe or
treat all children with suspected sepsis for at least 48 h is not
justified.
|
| |
|
|
citation
|
Dierig A, Berger C, Agyeman P K A, Bernhard-Stirnemann S, Giannoni
E, Stocker M, Posfay-Barbe K M, Niederer-Loher A, Kahlert C R, Donas
A, Hasters P, Relly C, Riedel T, Aebi C, Schlapbach L J, Heininger
U, Swiss Pediatric Sepsis Study . Time-to-Positivity of Blood
Cultures in Children With Sepsis. Front Pediatr 2018; 6:222.
|
| |
|
|
type
|
journal paper/review (English)
|
|
date of publishing
|
08-08-2018
|
|
journal title
|
Front Pediatr (6)
|
|
ISSN print
|
2296-2360
|
|
pages
|
222
|
|
PubMed
|
30135859
|
|
DOI
|
10.3389/fped.2018.00222
|
additional links & downloads
