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Should all children admitted with community acquired pneumonia have blood cultures taken?

Eng Meng Lai1, Anna Marie Nathan, Jessie A de Bruyne

  • 1Department of Pediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.

Indian Journal of Pediatrics
|September 3, 2014
PubMed

Insights

Blood cultures rarely identify pathogens in children with community-acquired pneumonia (CAP) and seldom change antibiotic treatment. High contamination rates suggest current practices for pediatric CAP blood cultures need review.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Microbiology

Background:

  • Community-acquired pneumonia (CAP) is a common reason for pediatric hospitalization.
  • Empiric antibiotic therapy is standard, but pathogen identification guides treatment adjustments.
  • Blood cultures are often performed to identify causative organisms in hospitalized children with CAP.

Purpose of the Study:

  • To assess the diagnostic yield of blood cultures in children hospitalized with CAP.
  • To determine the influence of blood culture results on empiric antibiotic treatment decisions.
  • To evaluate the contamination rate of blood cultures in this pediatric population.

Main Methods:

  • Prospective study in a Malaysian tertiary hospital over one year.
  • Included children aged 1 month to 12 years admitted with CAP, with blood cultures before IV antibiotics.
  • Excluded children with specific comorbidities or conditions.

Main Results:

  • 171 children were enrolled; 1.2% had positive blood cultures.
  • The blood culture contamination rate was 1.8%.
  • Antibiotic treatment was adjusted based on blood culture results in only one patient.

Conclusions:

  • Blood cultures have a low yield and minimal impact on antibiotic management in pediatric CAP.
  • High contamination rates were observed, questioning the utility of routine blood cultures.
  • Current recommendations for blood cultures in pediatric CAP require re-evaluation.
Abstract

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