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Detection of bloodstream infections in children
1Department of Pediatrics, Children's Hospital, Washington, DC.
Insights
Accurate detection of bacteremia in children requires specific blood culture methods. This review compares techniques for pediatric blood cultures, aiding laboratory selection.
Area of Science:
- Clinical Microbiology
- Pediatric Infectious Diseases
Background:
- Accurate and timely detection of bacteremia is crucial for treating infected children.
- Standard adult blood culture protocols may not be optimal for pediatric specimens.
Purpose of the Study:
- To review methods for detecting bacteremia in pediatric blood cultures.
- To compare the strengths and weaknesses of various blood culture techniques for children.
- To provide recommendations for selecting appropriate blood culture methods in clinical laboratories.
Main Methods:
- Review of blood culture specimen collection in children (skin disinfection, volume, timing).
- Analysis of diverse blood culture methods: conventional, radiometric, infrared spectroscopic, manometric broth cultures, biphasic agar/broth, and lysis direct plating.
- Evaluation of the advantages and disadvantages of each method.
Main Results:
- Pediatric blood culture requires specialized approaches compared to adults.
- Various methods (broth, biphasic, lysis) offer different benefits and drawbacks.
- Laboratory resources and staffing influence method selection.
Conclusions:
- No single blood culture method is universally superior for pediatric bacteremia detection.
- Method selection should consider specimen collection, laboratory capabilities, and workflow.
- Optimizing pediatric blood culture protocols enhances patient care.
Abstract:
A critical responsibility of the clinical microbiology laboratory serving clinicians who care for infected children is accurate and timely detection of bacteremia. Blood culture protocols which are suitable for processing adult specimens are not necessarily the first choice for processing pediatric specimens. In this review, the following aspects of detection of bacteremia in children are covered: obtaining blood culture specimens from children, including skin disinfection, specimen volume and timing of specimen collection; the array of blood culture methods available, focusing upon conventional, radiometric, infrared spectroscopic and manometric broth cultures, as well as biphasic agar/broth and lysis direct plating techniques: the strengths and weaknesses of the various methods; and recommendations to laboratories for selection of a blood culture method based upon the laboratory's staffing level.